T 

T4425s 

1911 


UNIVERSITY 

OF  CALIFORNIA 

LOS  ANGELES 


LAW  LIBRARY 


WISCONSIN  LIBRARY  COMMISSION 
LEGISLATIVE  REFERENCE  DEPARTMENT 
COMPARATIVE  LEGISLATION  BULLETIN 
NTo.  24 


STATE  LEGISLATION  CONCERNING 
TUBERCULOSIS 


LEO.  F.  TIEFENTHALER 


MADISON,  WISONSTN 
MARCH,  mu 


INTRODUCTION. 

The  Legislative"  Reference  Department  has  had  many 
requests  for  information  as  to  what  other  states  are 
doing  to  prevent  the  spread  of  tuberculosis.  The  Wis- 
consin Anti-tuberculosis  Association  has  furnisheji  the 
data  for  this  bulletin  and1  the  Legislative  Reference  De- 
partment has  cooperated  in  its  publication. 

CHARLES  MCCARTHY, 
Legislative  Reference  Department. 


STATE  LEGISLATION  CONCERNING 
TUBERCULOSIS 


LEO  F.  TIEFENTHALER 


COMPARATIVE  LEGISLATION  BULLETIN— No  24— MARCH,  191  r 

Prepared  with  the  co-operation  of  the  Political  Science 

Department  of  the  University  of  Wisconsin,  and 

the  Wisconsin  Anti-Tuberculosis 

Association 


WISCONSIN  LIBRARY  COMMISSION 

LEGISLATIVE  REFERENCE  DEP'T 

MADISON,  Wis. 

1911 


CONTENTS 

Page 

General  Tuberculosis    Laws 3 

District,  County,  and  Municipal  Hospitals,,  Sanatories  and 

.Dispensaries     16 

'State  Hospitals,  Sanatoria  and  Dispensaries 24 

Expectoration 33 

^Dissemination  of  Knowledge  concerning  Tuberculosis ....  37 

Miscellaneous  Provisions   39 

Bovine   Tuberculosis   40 

Public  and  Private  expenditures  in  1909  and  1910 54 

Bibliography 56 


GENERAL  TUBERCULOSIS  LAWS 


Maryland  in  1904  was  the  first  'state  to  enact  a  com- 
prehensive measure  concerning  tuberculosis.  Similar 
laws  were  enacted  in  Wisconsin  in  1905  and  1907,  New 
York  in  1908,  Connecticut,  Kansas,  Maine  and  Michigan 
in  1909  and  New  Jersey  in  1910.  More  limited  laws 
have  been  passed  by  Washington  in  1899,  Vermont  in 
1902,  New  Hampshire  and  Utah  in  1905,  Alabama  in 
1907,  Virginia  in  1908,  Pennsylvania  and  Rhode  Island 
in  1909  and  Mississippi  in  1910. 

The  Kansas  statute  is  a  good  example  of  a  compre- 
hensive measure: 

Chapter  227,  Laws  of  Kansas,  1909 

Relating  to  powers  and  duties  of  local -health  officers 
and  boards  of  health  for  the  protection  of  people  from 
tuberculosis. 

Senate  bill  No.  209 

AN  ACT  defining  the  powers  and  duties  of  local  health 
officers  and  board  of  health  in  the  matter  of  the  pro- 
tection of  the  people  of  the  state  of  Kansas  from  the 
disease  known  as  tuberculosis,  and  providing  penalties 
for  the  violation  of  the  provisions  of  this  act,  and  re- 


pealing  all  acts  and  parts  of  acts  in  so  far  as  they  con- 
flict with  the  provisions  of  this  act. 
Be  it  enacted  by  the  Legislature  of  the  State  of  Kan- 
sas. 

SECTION  1.  Tuberculosis  is  hereby  declared  to  be  an 
infectious  and  communicable  disease,  dangerous  to  the 
public  health.  It  shall  be  the  duty  of  every  physician  in 
the  state  of  Kansas  to  report  in  writing,  on  a  form  to  be 
furnished  as  hereinafter  provided,  the  name,  age,  sex, 
color,  occupation,  place  where  last  employed,  if  known, 
and  address  of  every  person  known  by  said  physician  to 
have  tuberculosis,  to  the  county  health  officer;  or  in 
cities  of  the  first  class  to  the  city  healh  officer,  in  which 
said  person  resides  within  twenty-four  hours  after  such 
fact  comes  to  the  knowledge  of  said  physician.  It  shall 
also  be  the  duty  of  the  chief  officer  having  charge  for  the 
time-being  of  any  hospital,  dispensary,  asylum,  or  other 
similar  private  or  public  institution  in  said  state  of  Kan- 
sas, to  report  in  like  manner  the  name,  age,  sex,  color, 
occupation,  place  where  last  employed,  if  known,  and 
previous  address  of  every  patient  having  tuberculosis 
who  comes  into  his  care  or  under  his  observation  within 
twenty-four  hours  thereafter. 

SECTION  2.  It  shall  be  the  duty  of  the  bacteriologist 
of  the  laboratory  of  the  State  Board  of  Health,  when  so 
requested  by  any  physician  or  by  authorities  of  any  hospi- 
tal or  dispensary,  to  make,  or  cause  to  be  made,  a  micro- 
scopical examination  of  the  sputum  forwarded  to  said 
bacteriologist  as  that  of  a  person  having  symptoms  of 
tuberculosis,  which  shall  be  forwarded  to  such  officer  ac- 
companied by  a  blank  giving  name,,  age,  sex,  color,  occu- 
pation, place  where  last  employed,  if  known,  and  address 


LEGISLATION    CONCERNING  TUBERCULOSIS  5 

of  the  person  whose  sputum  it  is.  It  shall  be  the  duty 
of  said  bacteriologist  promptly  to  make  a  report  of  the 
results  of  such  examination,  free  of  charge,  to  the  phy- 
sician or  person  upon  whose  application  the  same  is  made. 
SECTION  3.  It  shall  be  the  duty  of  every  health  of- 
ficer of  a  city  or  county  to  cause  all  reports  made  in  ac- 
cordance with  the  provisions  of  the  first  section  of  this 
act,  and  also  all  results  of  examinations  showing  the  pres- 
ence cf  the  bacilli  of  tuberculosis  made  in  accordance 
with  the  provisions  of  the  second  section  of  this  act, 
to  be  recorded  in  a  register,  of  which  he  shall  be  the  cus- 
todian. Such  register  shall  not  be  open  to  inspection  by 
any  person  other  than  the  health  authorities  of  the  state 
and  of  said  city  or  county,  and  said  health  authorities 
shall  not  permit  any  such  report  or  record  to  be  divulged 
so  as  to  disclose  the  identity  of  the  person  to  whom  it 
relates,  except  as  may  be  necessary  to  carry  into  effect 
the  provisions  of  this  act. 

SECTION  4.  In  case  of  the  vacation  of  any  apartment 
or  premises  by  the  death  or  removal  therefrom  of  a  per- 
son having  tuberculosis,  it  shall  be  the  duty  of  the  attend- 
ing physician,  or  if  there  be  no  such  physician,  or  if 
such  physician  be  absent,  of  the  owner,  lessee,  occupant, 
or  other  person  having  charge  of  the  said  apartments 
or  premises,  to  notify  the  health  officer  of  said  city  or 
county  of  said  death  or  removal  within  twenty-four  hours 
thereafter,  and  such  apartments  or  premises  so  vacated 
shall  not  again  be  occupied  until  duly  disinfected,  cleansed 
or  renovated  as  hereinafter  provided. 

'SECTION  5.  When  notified  of  the  vacation  of  any 
apartments  or  premises  as  provided  in  section  4  hereof, 
the  local  health  officer,  or  one  of  his  assistants  or  depu- 


6  LEGISLATION    CONCERNING  TUBERCULOSIS 

ties,  shall  within  twenty- four  hours  thereafter  visit  said 
apartments  or  premises  and  shall  order  and  direct  that, 
except  for  purposes  of  cleansing  or  disinfection,  no  in- 
fected article  shall  be  removed  therefrom  until  properly 
and  suitably  cleansed  6r  disinfected,  and  said  health  of- 
ficer shall  determine  the  manner  in  which  such  apart- 
ments or  premises  shall  be  disinfected,  cleansed  or  reno- 
vated in  order  that  they  may  be  rendered  safe  and  suit- 
able for  occupancy.  If  the  health  authorities  determine 
that  disinfection  is  sufficient  to  render  them  safe  and  suit- 
able for  occupancy,  such  apartments  or  premises,  together 
with  all  infected  articles  therein,  shall  immediately  be 
disinfected  by  the  health  authorities  at  public  expense, 
or,  if  the  owner  prefers,  by  the  owner  at  his  expense,  to 
the  satisfaction  of  the  health  authorities.  Should  the 
health  authorities  determine  that  such  apartments  or 
premises  are  in  need  of  thorough  cleansing  and  renova- 
tion, a  notice  in  writing  to  this  effect  shall  be  served  upon 
the  owner  or  agent  of  said  apartments  or  premises,  and 
said  owner  or  agent  shall  thereupon  proceed  to  the  cleans- 
ing renovating  of  such  apartments  or  premises  in 
accordance  with  the  instruction  of  the  health  authorities, 
and  such  cleansing  and  renovation  shall  be  done  at  the 
expense  of  the  said  owner  or  agent. 

SECTION  6.  In  case  the  orders  or  direction  of  the  local 
health  officer  requiring  the  disinfection,  cleansing  or  ren- 
ovation of  any  apartments  or  premises  or  any  article 
therein,  as  hereinbefore  provided,  shall  not  be  complied 
with  within  forty-eight  hours  after  such  orders  or  di- 
rections shall  be  given,  the  health  officer  may  cause  a 
placard  in  word's  and  form  substantially  as  follows  to 
be  placed  upon  the  door  of  the  infected  apartments  or 


LEGISLATION    CONCERNING  TUBERCULOSIS          1 

premises.  "Tuberculosis  is  a  communicable  disease. 
These  apartments  have  been  occupied  by  a  consumptive 
and  may  be  infected.  They  must  not  be  occupied  until 
the  order  of  the  health  officer  directing  their  disinfection 
or  renovation  has  been  complied  with.  This  notice  must 
not  be  removed  under  the  penalty  of  law,  except  by  the 
health  officer  or  other  duly  authorized  official." 

SECTION  7.  Any  person  having  tuberculosis  who  shall 
dispose  of  his  sputum,  saliva  or  other  bodily  secretion  or 
excretion  so  as  to  cause  offense  or  danger  to  any  person 
or  persons  occupying  the  same  room  or  apartment,  house, 
or  part  of  house,  shall,  on  complaint  of  any  person  or 
persons  subjected  to  such  offense  or  danger,  be  deemed 
guilty  of  an  offense,  and  any  person  subjected  to  such 
offense  may  make  complaint  in  person  or  writing  to  the 
health  officer  of  any  city  or  county  where  the  offense 
complained  of  is  committed.  And1  it  shall  be  the  duty 
of  the  local  health  officer  receiving  such  complaint  to 
investigate,  and  if  it  appears  that  the  offense  complained 
of  is  such  as  to  cause  offense  or  danger  to  any  person 
occupying  the  same  room,  apartment,  house,  or  part  of 
house,  he  shall  serve  a  notice  upon  the  person  complained 
of,  reciting  the  alleged  cause  of  offense  or  danger  and 
requiring  him  to  dispose  of  his  sputum,  saliva  or  other 
bodily  secretion  or  excretion  in  such  a  manner  as  to  re- 
move all  reasonable  cause  of  offense  or  danger.  Any  per- 
son failing  or  refusing  to  comply  with  orders  or  regula- 
tions of  the  local  health  officer  of  any  city,  county,  or 
state,  requiring  him  to  cease  to  commit  such  offense,  shall 
be  deemed  guilty  of  a  misdemeanor,  and  on  conviction 
thereof  shall  be  fined  not  more  than  ten  dollars. 


8  LEGISLATION    CONCERNING  TUBERCULOSIS 

SECTION  8.  It  shall  be  the  duty  of  a  physician  attend- 
ing a  patient  having  tuberculosis  to  take  all  proper  pre- 
cautions and  to  give  proper  instructions  to  provide  for 
the  safety  of  all  individuals  occupying  the  same  house  or 
apartment,  and  if  no  physician  be  attending  such  pa- 
tient this  duty  shall  devolve  upon  the  local  health  officer ; 
and  all  duties  imposed  upon  physicians  by  any  sections 
of  this  act  shall  be  performed  by  the  local  health  officer 
in  all  cases  of  tuberculosis  not  attended  by  a  physician, 
or  when  the  physician  fails  to  perform  the  duties  herein 
specified,  and  shall  so  report. 

SECTION  9.  It  shall  be  the  duty  of  the  local  health 
officer  to  transmit  to  a  physician  reporting  a  case  of 
tuberculosis,  as  provided  in  section  1  of  this  act,  a  printed 
statement  and  report,  in  a  form  approved  by  the  secretary 
of  the  State  Board  of  Health,  naming  such  procedures 
and  precautions  as  in  the  opinion  of  the  said  secretary 
are  necessary  or  desirable  to  be  taken  on  the  premises  of 
a  tuberculosis  patient.  It  shall  be  the  duty  of  the  local 
health  authorities  to  keep  on  hand  an  ample  supply  of 
such  statements  and  reports  and  to  furnish  the  same  in 
sufficient  numbers  to  all  local  physicians.  Upon  receipt 
of  such  statement  and  report  the  physician  shall  either 
carry  into  effect  all  such  procedures  and  precautions  as 
are  therein  prescribed,  and  shall  thereupon  s'gn  and  date 
the  same  and  return  it  to  the  local  health  officer  without 
delay,  or  if  such  attending  physician  be  unwilling  or  un- 
able to  carry  into  effect  the  procedures  and  precautions 
specified,  he  shall  so  state  upon  this  report  and  immedi- 
ately return  the  same  to  the  local  health  officer,  and  the 
duties  therein  prescribed  shall  thereupon  devolve  upon 
said  local  health  officer,  who  shall  receive  the  fee  herein- 


LEGISLATION    CONCERNING  TUBERCULOSIS          9 

after  provided  as  payment  of  the  services  of  the  physi- 
cian if  he  comply  with  the  duties  herein  prescribed.  Upon 
receipt  of  this  statement  and  report  the  local  health  of- 
ficer shall  carefully  examine  the  same,  and  if  satisfied 
that  the  attending"  physician  has  taken  all  necessary  and 
desirable  precautions  to  insure  the  safety  of  all  persons 
living  in  the  apartments  or  premises  occupied  by  the 
person  having  tuberculosis,  the  said  local  health  officer 
shall  issue  an  order  upon  the  treasurer  of  the  city  or 
county  in  favor  of  the  attending  physician  for  the  sum 
of  one  dollar,  thereupon  to  be  paid  out  of  the  general 
fund  of  said  city  or  county.  If  the  precautions  taken  or 
instructions  given  by  the  attending  physician  are.  in  the 
opinion  of  the  local  health  officer,  not  such  as  will  remove 
all  reasonable  danger  or  probability  of  danger  to  the  per- 
sons occupying  the  said  house  or  apartments  or  premises, 
the  local  health  officer  shall  return  to  the  attending  phy- 
sician the  report  with  a  letter  specifying  the  additional 
precautions  or  instructions  which  the  health  officer  shall 
require  him  to  take  or  give :  and  the  said  attending  phy- 
sician shall  immediately  take  the  additional  precautions 
and  give  the  additional  instructions  specified  and)  shall 
record  and  return  the  same  on  the  original  report  to  the 
local  health  officer.  It  shall  further  be  the  duty  of  the 
local  health  officer  to  transmit  to  the  physician  reporting 
any  case  of  tuberculosis  a  printed  requisition,  in  a  form 
approved  by  the  secretary  of  the  State  Board  of  Health. 
Upon  this  requisition  blank  shall  be  named  the  materials 
kept  on  hand  by  the  local  health  officer  for  the  prevention 
of  the  spread  of  tuberculosis,  and  it  shall  be  the  duty  of 
the  local  health  officer  to  supply  such  materials  as  may  be 
specified  in  such  requisition.  Any  physician  may  return 


10         LEGISLATION    CONCERNING  TUBERCULOSIS 

a  duly  signed  requisition  to  the  local  health  officer  for 
such  of  the  specified  materials  and  in  such  amount  as 
he  may  deem  necessary  to  aid  him  in  preventing  the 
spread  of  the  disease,  and  all  local  health  officers  shall 
honor,  as  far  as  possible,  a  requisition  signed  by  the  at- 
tending physician  in  such  case.  It  shall  be  the  duty  of 
every  local  health  officer  to  transmit  to  every  physician 
reporting  any  case  of  tuberculosis,  or  to  the  person  re- 
ported or  suffering  from  this  disease,  provided  the  lat- 
ter has  no  attending  physician,  a  circular  of  information 
approved  by  the  secretary  of  the  'State  Board  of  Health, 
and  which  shall  be  provided  in  sufficient  quantity  by  the 
local  authorities.  This  circular  of  information  shall  in- 
form the  consumptive  of  the  best  methods  of  treatment 
of  his  disease  and1  of  the  precautions  necessary  to  avoid 
transmitting  the  disease  to  others.  Any  physician  who 
shall  certify  falsely  as  to  any  of  the  precautions  taken 
to.  prevent  the  spread  of  infection  shall  be  deemed  guilty 
of  a  misdemeanor,  and  on  conviction  thereof  shall  be  sub- 
ject to  a  fine  of  not  more  than  fifty  dollars. 

SECTION  10.  Upon  the  recovery  of  any  person  having 
tuberculosis,  it  shall  be  the  duty  of  the  attending  physi- 
cian to  make  a  report  of  this  fact  to  the  local  health 
officer,  who  shall  record  the  same  in  the  records  of  his 
office,  and  shall  relieve  said  person  from  further  liability 
to  any  requirements  imposed  by  this  act. 

SECTION  11.  It  is  hereby  made  the  duty  of  the  local 
health  officer  to  return  to  the  State  Board  of  Health  on 
or  before  the  tenth  day  of  each  month,  a  copy  of  each 
report  of  tuberculosis  received  and  recorded  by  him  dur- 
ing the  preceding  month. 


LEGISLATION    CONCERNING  TUBERCULOSIS         11 

SECTION  12.  Any  person  violating  any  of  the  pro- 
visions of  this  act  shall  be  deemed1  guilty  of  a  misde- 
meanor, and  upon  conviction  thereof  shall  be  punished, 
except  as  herein  otherwise  provided,  by  a  fine  of  not  less 
than  five  dollars  nor  more  than  fifty  dollars. 

SECTION  13.  All  acts  and  parts  of  acts  in  .conflict  with 
the  provisions  of  this  act  are  hereby  repealed  in  so  far  as 
they  conflict  with  the  provisions  of  this  act. 

SECTION  14.  This  act  shall  take  effect  and  be  in  force 
from  and  after  its  publication  in  the  official  state  paper. 

Approved  February  26,  1909. 

Published  in  official  state  paper  March  2,  1909. 

The  principl  differences  beween  the  laws  of  Connecti- 
cut, Michigan,  Maine,  Maryland,  New  York  and  New 
Jersey  and  that  of  Kansas  are  as  follows: 

New  York.  (Consolidated  Laws,  Public  Health  Law, 
Chapter  45,  Sections  320  to  331;  Chapter  351,  1908.) 
The  examination  of  sputum  made  by  the  health  officer 
of  the  county,  town  or  village.  Duties  that  fall  to  the 
health  officers  of  counties  or  cities  in  Kansas  fall  to  the 
health  officers  of  the  county,  town  or  village. 

A'Vzt'  Jersey.  (Chapter  169,  1910.)  Physicians  are  to 
receive  ten  cents  from  the  local  authorities  for  each  name 
reported.  Examination  of  sputum  is  made  by  the  local 
health  officers.  Disinfection  at  public  expense  only  is 
provided  -for.  Requisition  for  materials,  the  report  of 
recovery  and  the  transmission  of  the  circular  of  infor- 
mation are  omitted. 

Maryland.  (Public  General  Law,  Article  43,  Sections 
56  to  65:  Chapters  412  and  399,  1904.)  No  provision  is 
made  for  the  examination  of  sputum  nor  for  the  clean- 


12         LEGISLATION    CONCERNING  TUBERCULOSIS 

ing  and  renovation  of  apartments  when  these  are  vacated 
by  death  or  removal.  The  physician  shall  receive  one 
dollar  and  fifty  cents  from  the  state  board  of  health  for 
filling  out  the  report  required.  Report  of  recovery  is 
not  required.  All  institutions  receiving  state,  city,  town 
or  county  aid  are  required  to  report  cases  to  the  state 
board  of  health,  but  no  mention  is  made  of  private  insti- 
tutions. The  state  board  of  health  is  required  to  keep  a 
register  of  persons  affected'  with  tuberculosis.  The  state 
board  of  health  is  authorized  to  issue  circulars  regarding 
the  prevention  and  cure  of  tuberculosis.  The  use  of  the 
placard  is  not  required. 

Maine.  (Chapter  78,  Public  Laws,  1909.)  Reports 
of  the  cases  of  tuberculosis  are  to  be  made  to  the  state 
board  of  health,  which  is  to  keep  a  record  of  such  cases. 
No  provision  is  made  for  the  examination  of  sputum. 
The  report  by  physicians  regarding  the  care  of  patients 
and  the  circular  of  information  are  not  required. 

Michigan.  (Act  27,  Public  Acts  1909.)  For  the  re- 
port of  each  case  of  tuberculosis  a  physician  is  to  receive 
fifty  cents  from  the  state  treasury.  The  local  health  of- 
ficer is  required  to  make  the  examination  of  sputum  or 
other  bodily  secretion  or  discharge.  The  disinfecting 
shall  be  done  at  public  expense.  No  provision  is  made 
for  the  requisition  for  supplies  or  the  report  to  be  filled 
out  by  the  physician  regarding  the  care  of  the  patient. 
Report  to  the  state  board  of  health  is  nor  required. 

Connecticut.  (Chaper  79,  1909.)  No  provisions  are 
made  for  the  examination  of  sputum,  requisition  for  sup- 
plies, physician's  report  regarding  the  care  of  the  patient, 
report  of  recovery  and  report  to  the  state  board  of  health. 


LEGISLATION    CONCERNING  TUBERCULOSIS         13 

The  provisions  of  the  laws  of  more  limited'  scope  are 
as  follows : 

Mississippi.  (Chapter  130,  1910.)  Physicians  are  re- 
quired to  report  cases  of  tuberculosis  to  the  state  board 
of  health.  The  board  shall  send  to  patients  thus  reported 
informal  on  on  the  care  and  treatment  of  patients,  the 
prevention  of  the  spread  of  tuberculosis  and  such  other 
matter  as  may  be  prescribed  by  the  board.  Death  or 
recovery  shall  be  reported  by  the  physician  to  the  state 
board  of  health.  Penalty  for  violation  shall  be  a  fine  of 
from  ten  dollars  to  fifty  dollars. 

AYu-  Hampshire.  (Chapter  17,  1905.)  It  shall  be 
the  duty  of  the  attending  physician  or  a  member  of  the 
patient's  family  or  household  to  report  every  death  from 
pulmonary  consumption,  or  the  removal  of  a  consump- 
tive patient,  to  the  local  board  of  health  within  one  week 
of  death  or  removal.  It  shall  be  the  duty  of  the  local 
board  of  health  within  one  week  after  such  notice  or 
information  from  any  other  source  to  cause  the  infected 
premises  to  be  thoroughly  d'sinfected  and  cleaned.  The 
methods  are  to  be  endorsed  and  recommended  by  the 
state  board  of  health. 

Rhode  Island.  (Chapter  386,  1909.)  All  physicians 
and  the  superintendent  of  institutions  deriving  part  or 
the  entire  support  from  the  state  shall  report  cases  to  the 
state  board  of  health.  The  board  shall  keep  a  register 
of  cases  reported.  The  register  shall  not  be  open  to 
public  inspection. 

Virginia.  (Chapter  41,  1908.)  The  person  in  charge 
of  any  institution  (including  prisons  and  almshouses> 
supported  entirely  or  in  part  by  state,  city,  town  or  county 
funds  shall  report  cases  of  tuberculosis  to  the  state  board 


14         LEGISLATION    CONCERNING  TUBERCULOSIS 

of  heailth.  Tuberculosis  patients  in  such  institutions 
shall  be  separated  from  the  other  inmates.  The  house- 
holder, physician  or  other  person  having  knowledge 
thereof  shall  inform  the  local  board  of  health  of  apart- 
ments vacated  by  death  or  removal  of  persons  affected 
with  tuberculosis.  The  local  board  of  health  shall  dis- 
infect such  premises. 

Washington.  (General  Statutes,  Sections  5550  to  5554, 
p.  117, 1899.)  All  practicing  physicians  in  cities  of  the  first 
and  second  class  sha'll  report  cases  of  tuberculosis  within 
five  days  to  the  local  board  of  health.  The  board  shall  keep 
a  record  of  these  cases  which  shall  not  be  open  to  public 
inspection.  The  board  shall  furnish  each  patient  with 
printed  instructions  unless  the  attending  physician  shall 
request  it  not  to  do  so.  When  the  infected  premises  are 
vacated  the  owners  shall  disinfect  them  at  his  own  ex- 
pense. Upon  the  owner's  failure  to  comply  with  this  re- 
quirement the  board  of  health  shall  disinfect  and  the 
costs  thereof  shall  be  a  lien  against  the  premises. 

Wisconsin.  (Chapter  93,  1907,  amending  Chapter  192, 
1905.)  Every  physician,  or  person,  or  owner,  agent, 
manager,  principal  or  supeintendent  of  every  public  or 
private  institution  or  dispensary,  hotel,  board'lng  or  lodg- 
ing house,  in  any  such  town,  incorporated  village,  or  city 
shall  report  to  the  department  of  health  thereof,  in  writ- 
ing, or  shall  cause  such  report  to  be  made  by  some  proper 
and  competent  person,  the  name,  age,  sex,  occupation, 
and  latest  address  of  every  person  afflicted  with  tubercu- 
losis, who  is  in  their  care,  or  who  has  come  under  their 
observation,  within  one  week  of  such  time. 

Upon  the  vacation  of  any  apartment  or  premises  by 
death  or  removal  of  any  person  sick  with  tuberculosis, 


the  person  or  physician  or  person  in  charge  shall  notify 
the  local  commissioner  of  health  within  twenty-four 
hours.  The  health  commissioner  or  health  officer  shall 
order  and  direct  disinfection.  In  case  there  is  no 
other  occupant  in  premises  or  apartment  he  shall  order 
renovation  and  disinfection  of  such.  If  orders  or 
directions  are  not  complied  with  the  health  commissioner 
or  health  officer  shall  cause  a  placard  as  follows  to  be 
placed  upon  the  door:  "Tuberculosis  is  a  communica- 
ble disease.  These  apartments  have  been  occupied  by  a 
consumptive  and  may  be  infected.  They  must  not 
be  occupied  until  the  order  of  the  health  commissioner 
or  health  officer  directing  their  renovation  and  disinfec- 
tion has  been  complied  with.  This  notice  must  not  be 
removed  under  a  penalty  of  law,  except  by  the  commis- 
sioner of  health,  or  an  authorized  officer." 

A  person  afflicted  with  tuberculosis  of  the  lungs  or 
larynx  shall  not  dispose  of  his  sputum,  saliva  or  other 
infectious  secretion  in  such  a  place  as  to  cause  offense  or 
clanger  of  contracting  the  disease  to  any  person.  A  per- 
son affected  with  tuberculosis  shall  provide  himself  with 
a  sputum  flask  or  other  receptacle  to  deposit  his  sputum, 
saliva  or  other  infectious  secretion  while  traveling  in 
any  public  conveyance  or  attending  any  public  place. 
The  contents  shall  be  burned  or  otherwise  disinfected. 
The  patient  and  the  person  in  attendance  and  authorities 
of  institutions  or  dispensaries  shall  take  precautionary 
measures  preventing  the  spread  of  pulmonary  tubercu- 
losis. For  the  purpose  of  this  act  railroad  conductors  or 
other  persons  in  charge  of  common  carriers  may  ex- 
ercise the  powers  of  sheriffs  and  constables.  The  pen- 
alty of  violation  of  the  act  shall  be  a  fine  of  not  less 


16         LEGISLATION    CONCERNING  TUBERCULOSIS 

than  five  dollars  or  more  than  one  hundred  dollars  or 
imprisonment  in  the  county  jail  for  not  less  than  five  days 
nor  more  than  ninety  days. 

Alabama.  (Page  893,  General  Acts,  1907.)  Tubercu- 
losis is  named  among  a  list  of  diseases  to  be  reported. 

Utah.  (Chapter  55,  1905.)  Every  physician  and  ev- 
ery superintendent  of  hospital  or  public  institution  shall 
report  to  ;the  state  board  of  health  every  case  of  tuber- 
culosis which  he  is  called  upon  to  treat  or  which  is  in 
such  hospital  or  public  institution. 

Vermont.  (No.  117,  1902.)  Every  physician  shall 
report  to  the  secretary  of  the  state  board  of  health  all 
cases  of  tuberculosis  that  come  under  his  treatment. 
The  secretary  shall  keep  a  careful  record  of  all  reported 
cases. 

Pennsylvania.  (Page  855,  1909.)  Physicians  shall  re- 
port cases  of  communicable  diseases,  among  which  tu- 
berculosis is  named. 

DIS^JIICT,    COUNTY    AND   MUNICIPAL   HOSPITALS,    SAN- 
ATORIA AND  DISPENSARIES 

New  York.  (Chapter  341,  1909.)  The  board  of 
supervisors  of  any  county  may  vote  to  establish  county 
hospitals  for  tuberculosis.  The  board  shall  then  have 
power  to  acquire  property,  to  erect  buildings  (if  ap- 
proved by  the  board  of  health),  to  cause  to  be  assessed, 
levied  and  collected  such  sums  as  it  shall  deem  neces- 
sary, to  borrow  money,  to  issue  county  obligations  there- 
for. Detailed  provisions  are  made  for  the  management 
of  the  hospitals.  The  patients  or  relatives  shall  pay 
according  to  their  ability  to  pay.  If  the  patient  or  rela- 


LEGISLATION  CONCERNING  TUBERCULOSIS      i? 

tives  are  unable  to  pay  in  whole  or  in  part  the  differences 
shall  be  paid  by  the  county.  Patients  from  other  coun- 
ties not  having  a  hospital,  shall  be  admitted  to  the  county 
hospital  on  the  application  of  the  superintendent  of  poor 
of  his  own  county  if  there  is  a  vacancy  in  the  hospital. 
Such  patient  is  a  charge  against  his  home  county.  He 
or  his  relatives  shall  pay,  in  whole  or  in  part  according 
to  their  financial  ability,  the  cost  of  the  maintenance  of 
the  patient.  When  a  tuberculosis  hospital  exists  in  con- 
nection with  a  county  almshouse  the  board  of  supervisors 
may  appoint  a  board  of  managers  for  the  hospital.  They 
shall  be  subject  to  the  provisions  of  this  act. 

(Consolidated  Laws,  Public  Health  Law;  Chapter  45, 
Section  319,  Consolidated  Laws;  Chapter  171,  1909.) 
A  hospital  for  tuberculosis  shall  not  be  established 
in  any  town,  unless  an  application  is  filed  with  the 
commissioner  of  health  giving  the  location  and  char- 
acter of  the  proposed  hospital.  A  day  shall  be  fixed  for 
a  public  hearing  before  the  state  commissioner  of  health 
and  the  local  health  officer.  Notice  hereof  shall  be  pub- 
lished. The  determination  of  the  state  health  commis- 
sioner and  the  local  health  officer  is  final.  If  these  are 
unable  to  agree  then  the  state  commissioner  of  health, 
lieutenant  governor,  and  speaker  of  the  assembly  shall 
decide,  (with  or  without  a  hearing).  Such  determina- 
tion shall  be  final  and  conclusive. 

(Chapter  21,  Sections  140,  141,  142,  Consolidated 
LI.WS,  General  City  Law.)  Cities  of  the  first  class  may 
maintain  outside  their  limits,  but  not  within  the  corporate 
limits  of  any  other  city  or  any  village,  with  the  approval 
of  the  state  board  of  health,  hospitals  for  tuberculisis. 
All  tuberculosis  hospitals  now  or  hereafter  maintained 


18         LEGISLATION    CONCERNING  TUBERCULOSIS 

by  cities  of  the  first  class  shall  be  subject  to  the  local 
board  of  health. 

New  Jersey.  (Chapter  88,  1910,  as  amended  by 
Chapter  207,  1910.)  The  New  Jersey  law  for  the  erec- 
tion and  maintenance  of  county  hospitals  is  almost  iden- 
tical with  the  New  York  law.  A  limit  is  set  to  tne  bond 
issue  at  one-tenth  of  one  per  cent  of  the  total  taxable 
ratables  of  such  county. 

(Chapter  66,  1910).  The  consent  of  the  state  board 
is  ^necessary  to  establish  hospitals  and  sanitaria  for  tu- 
berculosis. Application  shall  be  made  to  the  state  board 
of  health  giving  the  name  of  the  city,  town,  borough, 
township  or  other  municipality  and  with  a  descriptive 
map  of  the  premises.  A  pub'ic  hearing  shall  be  held  on 
the  application,  after  which  the  board  grants  or  with- 
holds consent  and  approval.  The  consent  of  the  local 
boards  is  not  necessary  for  the  erection  of  the  institu- 
tion or  for  bringing  persons  to  such  institutions  from 
points  within  or  without  the  state. 

Ohio.  (Page 62,  1908,  as  amended,  page  86,  1909,  and 
page  363, 1910. )  It  shall  be  unlawful  to  keep  a  person  suf- 
fering from  pulmonary  tuberculosis  in  any  county  infirm- 
ary except  in  separate  buildings  to  be  provided  and  used 
for  that  purpose  only.  The  board  of  county  commission- 
ers may  construct  a  county  hospital  for  tuberculosis.  If  the 
funds  are  not  available  the  county  commissioners  shall 
levy  and  set  aside  a  sum  necessary,  and  may  issue  and 
sell  bonds  in  anticipation  of  the  levy.  The  commission- 
ers and  infirmary  directors  of  any  county  may  contract 
with  another  county  or  municipality,  when  such  hospital 
has  been  constructed,  for  the  care  and  treatment  of  resi- 
dents of  the  former  county  at  actual  cost.  The  probate 


LEGISLATION    CONCERNING  TUBERCULOSIS         19 

judge  may  remove  a  patient  of  an  infirmary  if  suffering 
from  tuberculosis  to  a  county  hospital  for  tuberculosis  of 
some  other  county.  Patients  admitted  otherwise  then 
from  an  infirmary  shall  pay  not  more  than  three  dollars 
per  week. 

The  state  board  of  health  has  general  supervision  over 
county  hospitals. 

The  commissioners  of  any  two  or  more  counties  not  to 
exceed  five  may  form  themselves  into  a  joint  board  and 
establish  a  district  hospital. 

The  formation  of  a  board  of  trustees  and  detailed  pro- 
visions for  the  conduct  of  the  hospital  are  given. 

The  division  of  the  cost  among  such  counties  shall  be 
by  the  total  number  of  days  the  patients  from  each  county 
spent  in  the  hospital,  but  the  sum  paid  by  patients  from 
each  county  shall  be  deducted. 

Illinois.  (Page  162,  1909.)  Each  county  shall  have 
power  to  purchase  and  hold  real  estate  upon  which  may 
be  erected  and  maintained  by  the  county  a  sanatorium  for 
the  treatment  of  the  residents  of  the  coiinty  who  may  be 
afflicted  with  tuberculosis,  to  purchase,  hold  and  use  all 
necessary  personal  property  for  the  proper  care  and 
maintenancee  of  such  real  estate  and'  sanatorium,  and  to 
cause  to  be  erected  and  maintained  all  suitable  buildings 
for  a  tuberculosis  sanatorium. 

Minnesota.  (Chapter  347,  1909.)  The  board  of 
county  commissioners  in  any  county  in  the  state  shall 
have  power  to  maintain  a  public  sanatorium  for  the  treat- 
ment and  care  of  persons  afflicted  with  tuberculosis.  In 
such  case  a  county  sanatorium  commission  shall  be  chosen 
by  the  county  commissioners  and  approved  by  the  state 
board  of  health,  one  of  which  commission  shall  be  a  physi- 


cian.  Two  or  more  counties  may  unite  in  acquiring,  es- 
tablishing, equipping  and  maintaining  such  a  sanatorium. 
The  appropriation  for  establishing  and  equipping  the 
sanatorium  shall  not  exceed  twenty  thousand  dollars. 
The  tax  levy  for  the  equipment  and  maintenance  shall 
not  exceed  four  tenths  of  one  mill  on  the  dollar  of  as- 
sessed valuation. 

Iowa.  (Chapter  26,  1909.)  Counties  are  empowered 
to  establish  public  county  hospitals.  The  board  of  trus- 
tees are  authorized  to  provide  a  department  for  the  treat- 
ment of  persons  suffering  from  tuberculosis.  The  board 
of  trustees  shall  determine  whether  the  patients  are  sub- 
jects for  charity.  The  board  of  supervisors  of  any 
county,  when  no  suitable  provision  has  been  made  for 
the  care  of  its  indigent  tuberculous  residents,  may  con- 
tract with  the  board  of  hospital  trustees  of  any  public 
hospital  for  the  care  of  such  persons  in -the  sanitorium 
department  of  said  hospital,  upon  such  reasonable  terms 
as  may  be  agreed  upon. 

Oregon.  (Chapter  198,  1909.)  Any  county  or  city  of 
ten  thousand  may  levy  a  tax  to  establish  and  maintain- a 
tuberculosis  sanitarium.  Upon  the  application  of  one 
hundred  voters  the  question  shall  be  referred  to  the  people 
at  election.  The  sanitarium  shall  be  free  to  the  inhabi- 
tants of  the  city  or  county.  It  shall  be  subjec  to  the  rules 
and  regulations  of  the  state  board  of  health.  The  county 
court  with  the  approval  of  the  county  commissioners  or 
the  mayor  with  the  approval  of  the  council  shall  appoint 
a  board  of  three  directors.  This  board,  shall  have  power 
to  purchase  a  site  and  erect  the  hospital  with  the  approval 
of  the  state  board  of  health  and  to  appoint  persons  to 
have  charge  of  the  hospital. 


LEGISLATION    CONCERNING  TUBERCULOSIS         21 

Connecticut.  (Chapter  120,  1909.)  As  necessity 
arises  there  shall  be  erected  in  each  county  a  home  to  be 
used  for  the  care  and  treatment  of  persons  afflicted  with 
tuberculosis.  Three  of  these  shall  be  erected  as  soon  as 
poss  ble  after  the  appointment  of  a  board  of  directors  of 
three  by  the  governor.  The  homes  in  the  other  counties 
shall  be  erected  when  the  recommendation  of  the  board 
therefor  has  been  approved-  by  the  general  assembly. 
The  cost  of  construction  and  equipment  necessary  for  the 
work  of  the  homes  shall  be  paid  by  the  state.  Patients 
in  town  almshouses  or  county  temporary  homes  suffering 
with  tuberculosis  shall  be  removed  to  a  reception  home 
for  tubercular  patients.  Any  resident  of  the  state 
afflicted  with  tuberculosis  shall  be  admitted  to  the  home  in 
the  county  of  his  residence  or  in  some  other  county.  If 
patients  are  able  they  shall  pay  the  full  cost  of  their  treat- 
ment. Patients  who  are  unable  to  pay  full  cost  shall 
pay  a  minimum  rate  of  two  dollars  per  week,  and  of  the 
balance  of  the  cost  of  the  treatment  and  care  of  each  such 
patient  the  city  or  town  shall  pay  the  difference  between 
the  actual  rate  per  week  paid  by  the  patient  and  four 
dollars  per  week,  and  the  state  shall  pay  the  balance  of 
such  cost  over  and  above  four  dollars  per  week;  but 
the  total  cost  of  the  treatement  and  care  of  each  of 
such  patients  shall  not  exceed  ten  dollars  per  week.  If 
a  patient  is  unable  to  pay,  the  cost  of  treatment  shall  be 
four  dollars  per  week  to  the  town  or  city  from  which 
such  patient  is  sent.  Patients  of  filthy  or  immoral  habits 
shall  not  be  received  or  retained  unless  separate  accom- 
modation is  provided  them.  The  management  of  the 
homes  shall  be  under  the  direction  of  the  board  of  di- 
rectors, and  the  board  shall  appoint  the  necessary,  as- 


22         LEGISLATION    CONCERNING  TUBERCULOSIS 

sistants.  Each  member  of  the  board  shall  receive  a 
salary  of  twenty-five  hundred  dollars.  The  board  shall 
recommend  state  aid  for  sanatoria  under  private  manage- 
ment. The  act  carries  with  it  an  appropriation  of  one 
hundred  and  seventy-five  thousand  dollars. 

California.  (Chapter  591,  1909.)  The  state  board  of 
health  is  authorized  to  enter  into  contracts  with  tuber- 
culosis hospitals  for  the  treatment  at  public  expense  of 
indigent  residents  of  the  state  afflicted  with  incipient 
pulmonary  tuberculosis.  Each  county  of  the  state  is 
given  the  privilege  of  maintaining  at  its  own  expense  in 
these  institutions  such  a  number  of  indigent  patients  as 
its  board  of  supervisors  may  determine.  No  county  shall 
be  required  to  pay  more  than  one  dollar  per  day  per 
patient  for  all  medical  and  other  services.  Only  incipi- 
ent cases  shall  be  admitted. 

Georgia.  (Page  137,  1909.)  Municipalities  of  a  pop- 
ulation between  fifty-four  thousand  arid  seventy-five 
thousands  may  establish,  alone  or  with  the  county,  a  tu- 
berculosis sanatorium.  They  may  establish  two  depart- 
ments, one  for  indigent  and  the  other  for  pay  patients. 

Illinois.  (Page  43, 1908,  as  amended,  page  143,  1909.) 
Cities  and  villages  shall  have  power  to  establish  and 
maintain  public  sanatoria  for  persons  afflicted  with  tu- 
berculosis and  to  levy  a  tax  not  to  erxceed  one  mill  on  the 
dollar  annually  on  taxable  property  of  the  city  or  village. 
Upon  the  petition  of  one  hundred  voters  the  question  of 
the  tax  for  a  sanatorium  must  be  referred  to  vote. 
Upon  a  majority  vote  such  tax  shall  be  levied.  The 
mayor  or  president  of  the  board  of  trustees  shall  ap- 
point a  board  of  three  directors.  This  board  shall  make 
by-laws  and  rules  and  regulations,  appoint  assistants 


LEGISLATION    CONCERNING  TUBERCULOSIS         23 

and  carry  out  the  spirit  of  the  act.  The  sanatorium 
shall  be  free  for  inhabitants  of  the  city  or  village.  The 
board  shall  prescribe  terms  for  the  admission  of  non-resi- 
dents. The  board  shall  make  an  annual  report  to  the 
council  or  board  of  trustees.  All  reputable  physicians 
shall  have  equal  privileges  in  treating  patients  in  these 
sanatoria.  Donations,  bequests  or  devices  may  be  ac- 
cepted. 

Nebraska,  (Chapter  88,  1909.)  The  state  board  of 
health  shall  provide  a  list  containing  hospitals  suitably 
equipped  and  willing  to  accept  patients  afflicted  with  tu- 
berculosis. It  shall  send  a  copy  of  the  list  to  each  county 
clerk  in  the  state.  It  shall  prescribe  regulations  for  the 
care,  housing  and  nursing  of  such  patients  and  see  that 
they  are  complied  with.  The  modern  treatment  by  im- 
munigation  (vaccine  therapy)  is  made  obligatory  in  ad- 
dition to  the  open  air  and  other  sanitary  methods.  The 
charge  shall  not  exceed  seven  dollars  a  week.  Any  in- 
digent patient  who  is  afflicted  with  tuberculosis  disease 
of  the  respiratory  organs  of  a  curable  nature,  and  who 
has  been  a  resident  of  the  state  for  one  year  may  be 
admitted  to  one  of  these  hospitals.  The  county  board 
shall  pay  for  the  care  and  treatment  at  one  of  these 
hospitals.  No  patient  shall  be  admitted  unless  the  writ- 
ten application  has  been  approved,  after  an  examination 
and  hearing  by  the  county  judge  and  unless  he  has  re- 
ceived a  certificate  from  a  practicing  physician. 
*,  New  Hampshire.  (Chapter  152,  1909.)  The  state 
board  of  health  shall  establish  one  or  more  dispensaries 
for  the  more  thorough  detection  or  discovery  of  tubercu- 
losis and  for  the  free  treatment  of  indigent  cases  of 
tuberculosis  upon  the  petition  of  the  selectmen  of  any 


24        LEGISLATION    CONCERNING  TUBERCULOSIS 

town,  or  of  the  mayor  of  any  city,  or  upon  its  own  mo- 
tion. The  examining  physician  selected  by  the  state 
board  of  health  shall  examine  applicants.  He  may  for- 
ward sputum  for  examination  to  the  state  board  of  health. 
The  examination  shall  be  free  of  charge.  The  physician 
making  the  examination  shall  receive  from  the  state  one 
dollar  for  each  examination  in  which  germs  are  detected. 
Treatment  shall  be  free  to  all  indigent  patients.  The 
work  shall  be  carried  on  in  two  sections  for  the  care  and 
treatment  of  incipient  cases  and  for  advanced  cases. 
Cities  and  towns  are  authorized  to  raise  a  tax  not  to  ex- 
ceed one  tenth  of  one  per  cent  of  the  assessed  value  of 
the  taxable  property  of  the  city  or  town.  The  act  pro- 
vides for  an  annual  aporopriation  of  five  hundred  dollars. 
Rhode  Island.  (Chapter  400,  1909.)  No  person, 
corporation,  city  or  town  shall  establish  any  hospital  for 
the  treatment  of  patients  suffering  from  tuberculosis  un- 
less the  board  of  health  of  the  city  or  town  authorizes 
the  same. 

STATE  HOSPITALS,  SANATORIA  AND  DISPENSARIES. 

Alabama.  (Page  705,  1907.)  Alabama  sanatorium 
for  consumption  and  tuberculosis,  established  for  the  study 
of  tuberculosis,  disseminating  the  results  of  the  study, 
showing  the  best  methods  of  treating  it  and  preventing 
its  spread  and  for  the  care  and  treatment  of  such  per- 
sons as  may  be  admitted  to  the  sanatorium.  The  gover- 
nor, the  state  health  officer  and  five  other  members  ap- 
pointed by  tbe  governor,  three  of  whom  shall  be  physi- 
cians, shall  constitute  the  board  of  trustees.  The  board 
selects  a  superintendent.  Only  curable  cases  are  admit- 


LEGISLATION    CONCERNING  TUBERCULOSIS        25 

ted.  Charges  for  pay  patients  shall  be  determined  by 
the  board.  Indigent  patients  may  be  received;  the  cost 
of  maintenance  of  these  shall  not  exceed  four  dollars 
and  twenty  cents  per  week.  Ten  thousand  dollars  is 
appropriated  annually.  The  state  shall  pay  not  to  ex- 
ceed sixty  cents  per  day  for  each  indigent  patient. 

.-Irkansas.  (Act  378,  1909.)  The  Arkansas  Tubercu- 
losis 'Sanatorium  established.  Appropriations  are  made 
for  sum  of  fifty  thousand  dollars  for  the  site,  construc- 
tion and  equipment  and  for  sum  of  thirty  thousand  dol- 
lars for  its  maintenance.  A  board  of  trustees  of  six  mem- 
bers shall  be  appointed  by  the  governor.  The  board  shall 
appoint  a  medical  superintendent.  Indigent  and  pay  pa- 
tient may  be  admitted.  The  charge  shall  be  determined 
by  the  board. 

Connecticut.  (Chapter  120,  1909.)  The  state  shall 
pay  the  cost  of  the  construction  and  equipment  of  homes 
to  be  erected  in  the  various  counties.  The  state  shall  also 
pay  the  cost  over  and  above  four  dollars  per  week  of 
those  patients  who  pay  only  the  minimum  rate  of  two 
dollars  per  week,  provided  that  the  total  cost  shall  not 
exceed  ten  dollars  per  week. 

Delaware.  (Chapter  74,  1909.)  The  Delaware  State 
Tuberculosis  Commission  shall  consist  of  nine  members, 
three  from  each  county,  appointed  by  the  governor.  The 
commission  shall  have  power  to  send  indigent  patients 
to  sanatoria  for  treatment,  and  shall  pay  for  the  c*re, 
treatment  and  support  of  these  patients.  Persons  able 
to  pay  only  a  part  of  the  cost  of  their  maintenance  may 
be  assisted  by  the  commission.  The  commission  shall 
make  an  annual  report  to  the  governor. 

The  commission  is  directed   to  establish   at  least   one 


26        LEGISLATION    CONCERNING  TUBERCULOSIS 

dispensary  in  each  county  for  the  treatment  of  indigent 
consumptives  and  to  employ  the  necessary  assistants. 
Fifteen  thousand  dollars  is  appropriated  annually. 

Georgia.  (Page  101,  1908.)  The  act  establishes  a 
'State  Sanitarium  for  patients  afflicted  with  tuberculosis. 
The  board  of  managers,  two  from  each  congressional 
district,  shall  be  appointed  by  the  governor.  The  board 
shall  appoint  a  doctor  to  take  charge  of  the  institution 
and  other  assistants?  There  shall  be  two  departments, 
one  for  pay  and  'the  other  for  indigent  patients.  Charges 
shall  be  fixed  by  the  board. 

Indiana.  (Chapter  125,  1907.  )  The  act  establishes 
the  Hospital  for  Treatment  of  Tuberculosis.  The 
governor  shall  appoint  a  board  of  trustees  of  three  mem- 
bers. They  shall  receive  three  hundred  dollars  a  year 
and  one  hundred  dollars  expenses.  The  board  shall  ap- 
point a  superintendent.  Only  incipient  cases  are  ad- 
mitted. Indigents  shall  be  county  charges.  The  cost  of 
maintenance  shall  not  exceed  five  dollars  a  week.  The 
county  shall  pay  the  part  of  the  cost  that  is  unpaid  by 
the  partial  pay  patients.  Pay  patients  may  also  be  ad- 
mitted. The  appropriation  is  thirty  thousand  dollars. 
Chapter  189,  1909,  makes  an  appropriation  of  one  hun- 
dred thirty  thousand  dollars. 

loiua.  (Chapter  120  1906,  as  amended  by  Chapter 
147,  1907.)  State  sanatorium  for  the  treatment  of 
incipient  tuberculosis  is  established.  The  board  of  con- 
trol of  state  institutions  shall  appoint  a  superintendent 
and  other  employees.  The  per  capita  cost  shall  not  ex- 
ceed thirty  dollars  per  month.  The  patients  shall  pay  if 
they  are  able. 


LEGISLATION    CONCERNING  TUBERCULOSIS        27 

Kentucky.  (Page  44,  1908.)  Appropriations  were 
made  to  private  sanatoria. 

Maine.  (Chapter  50,  Resolves  1907.)  Fifty  thousand 
dollars  appropriated  for  a  building  for  the  isolation  of 
the  tuberculi  insane  of  the  two  state  asylums. 

Maryland.  (Chapter  308,  1906.)  The  Maryland  Tu- 
berculosis Sanatorium  is  established.  The  board  of  man- 
agers shall  consist  of  the  governor,  state  treasurer,  comp- 
troller of  the  treasury  and  six  other  persons  appointed 
by  the  governor.  The  appropriation  is  one  hundred 
thousand  dollars. 

(Chapter  429,  1906.)  The  act  makes  an  appropriation 
of  thirty-five  thousand  dollars  to  the  Hospital  for  con- 
sumptives of  Maryland. 

Massachusetts.  (Revised  Laws,  1902,  Chapter  88.) 
Massachusetts  state  sanatorium  was  established  in  1895. 

(Chapter  474,  1907.)  The  act  establishes  three  sana- 
toria for  tubercular  patients.  The  governor  shall  appoint 
a  board  of  trustees  of  seven  members.  The  trustees  may 
appoint  physicians  and  the  necessary  assistants.  The 
charges  are  four  dollars  per  week.  Charges  for  an  in- 
digent not  having  a  known  settlement  shall  be  paid  by  the 
state,  for  an  indigent  having  a  known  settlement,  by  the 
place  of  settlement.  Patients  or  persons  bound  by  law 
to  maintain  them  shall  pay  if  they  are  are  able  to  pay. 
When  the  sanatoria  are  completed  the  trustees  shall  as- 
sume the  powers  and  duties  of  the  Massachusetts  state 
sanatorium. 

Michigan.  (Page  363,  1905.)  A  state  sanatorium 
for  tuberculous  persons  is  established.  The  governor 
shall  appoint  a  board  of  trustees  of  six  citizens,  four  of 
whom  shall  be  physicians.  The  board  shall  appoint  a 


28        LEGISLATION    CONCERNING  TUBERCULOSIS 

medical  superintendent,  who  shall  be  a  physician.  The 
superintendent  shall  appoint  all  assistants.  Both  indi- 
gent and  pay  patients  shall  be  admitted.  Indigent  patients 
are  county  charges.  The  rate  for  these  shall  not  be  less 
than  five  dollars,  or  more  than  seven  dollars  a  week ;  the 
rate  for  pay  patients  shall  be  determined  by  the  board. 

Minnesota.  (Chapter  316,  1903.)  The  governor 
shall  appoint  five  licensed  physicians  as  the  advisory  com- 
mission of  the  state  sanatorium  for  consumptives..  The 
state  board  of  control  shall  appoint  a  licensed  physician 
as  superintendent.  The  board  shall  fix  the  amounts  to 
be  charged.  Indigent  patients  shall  be  county  charges. 
Only  incipient  cases  shaill  be  admitted. 

Missouri.  (Revised  Statutes,  Sections  1454  to  1469; 
page  306,  1907.)  The  Missouri  state  sanatorium  is  estab- 
lished. The  governor  shall  appoint  a  board  of  managers 
of  five  members,  not  less  than  two  of  whom  shall  be 
practicing  physicians.  The  board  shall  elect  a  superin- 
tendent and  other  employees.  The  superintendent,  the 
steward  and  the  treasurer  shall  make  biennial  reports. 
Free  patients  shall  be  charged  upon  the  counties  or  the 
city  of  St.  Louis.  The  rate  shall  not  exceed  five  dollars 
a  week.  Pay  patients  are  admitted,  but  preference  is 
given  to  the  indigent  patients.  The  board  shall  fix  the 
charges  for  pay  patients.  Only  incipient  cases  are  ad- 
mitted. 

New  Hampshire.  (Chapter  92,  1905.)  The  act  es- 
tablishes the  New  Hampshire  State  Sanatorium.  The 
governor,  with  advice  and  consent  of  -the  council,  shall 
appoint  a  board  of  trustees  of  five  persons.  The  board 
shall  appoint  a  superintendent,  who  shall  be  a  physician, 
and  other  necessary  employees.  Pay  and  free  patients 


LEGISLATION    CONCERNING  TUBERCULOSIS        29 

shall  be  admitted.  Charges  for  pay  patients  shall  be 
fixed  by  the  board.  The  state  shall  pay  the  amount  nec- 
essary to  make  up  the  deficit  of  those  who  are  able  to  pay 
but  a  part  of  their  maintenance.  The  trustees  shall  make 
an  annual  report  to  the  governor  and  council. 

Neiv  Jersey.  (Chapter  126, 1902,  as  amended  by  Chap- 
ter 178,  1907.)  The  New  Jersey  Sanatorium  for  Tuber- 
culous Diseases  is  established.  The  governor  with  the 
advise  and  consent  of  the  senate,  shall  appoint  a  board  of 
eight  managers  at  least  four  of  whom  shall  be  physicians. 
The  board  shall  appoint  a  superintendent,  who  shall  be 
a  physician,  and  other  assistants.  The  board  shall  make 
an  annual  report  to  the  governor.  Any  person  who  has 
been  a  resident  of  the  state  for  a  year  and  is  afflicted  with 
tuberculous  disease  of  the  respiratory  organs  of  a  cur- 
able nature  may  be  admitted.  Persons  of  sufficient  abil- 
ity to  pay  shall  pay  for  their  care  and  treatment  at  a  rate 
to  be  determined  by  the  board.  The  charges  of  persons 
who  have  had  a  residence  in  any  municipality  of  the  state 
for  one  year  and  who  are  received  at  the  request  of  the 
overseer  of  the  poor  of  that  municipality,  shall  be  paid  by 
that  municipality;  the  sum  shall  not  exceed  five  dollars 
per  week.  Persons  in  indigent  circumstances  who  have 
had  a  residence  in  the  state  for  one  year  and  who  do  not 
come  within  the  foregoing  two  classes  shall  be  treated 
without  cost. 

Xcw  York.  (Consolidated  Laws,  State  Charities  Law, 
Sections  150  to  163.)  New  York  state  hospital  for  the 
treatment  of  incipient  pulmonary  tuberculosis  is  estab- 
lished. The  governor,  with  the  advice  and  consent  of 
the.  senate,  shall  appoint  a  board  of  trustees  of  five  citi- 
zens, two  of  whom  shall  be  physicians.  The  board  shall 


30        LEGISLATION    CONCERNING  TUBERCULOSIS 

appoint  a  superintendent  who  shall  be  a  physician.  The 
superintendent  shall  appoint  the  other  employees.  The 
expense  of  transportation,  treatment,  maintenance  and 
the  actual  cost  of  articles  of  clothing  furnished  by  the 
hospital  to  poor  or  indigent  patients  shall  be  a  county, 
city  or  town  charge,  as  the  case  may  be.  Pay  patients 
shall  be  admitted  if  there  is  room  in  the  hospital,  but 
preference  shall  be  given  to  indigent  patients.  The  trus- 
tees shall  fix  the  charges  to  be  pa-id  by  pay  patients. 
Charges  for  free  patients  shall  not  exceed  five  dollars  per 
week. 

North  Carolina.  (Chapter  964,  190T,  as  amended 
Chapter  845,  1909.)  The  act  establishes  the  North  Caro- 
lina sanatorium  for  the  treatment  of  persons  afflicted  with 
tuberculosis.  A  board  of  directors  of  twelve  members 
shall  be  appointed  by  the  general  assembly.  The  super- 
intendent shall  be  a  skilled  physician.  He  shall  appoint 
the  subordinate  officers  and  employees.  The  board  shall 
make  an  annual  report  to  the  governor  and  the  general 
assembly.  The  act  carries  an  annual  appropriation  of 
five  thousand  dollars  besides  the  appropriation  of  fifteen 
thousand  dollars  for  the  establishment  of  the  sanatorium. 

North  Dakota.  (Chapter  137, 1909.)  The  North  Da- 
kota Tuberculosis  Sanitorium  is  established  by  the  act. 
Ten  thousand  dollars  is  appropriated. 

Ohio.  (General  Code  1910,  Sections  2052  to  2072.) 
The  Ohio  state  sanitorium  for  incipient  cases  is  estab- 
lished. Patients  shall  be  apportioned  among  the  several 
counties  in  proportion  to  their  population.  The  gov- 
ernor, with  the  advice  and  consent  of  the  senate  shall 
appoint  a  board  of  trustees  of  five  members.  The  board 
shall  appoint  a  superintendent  and  other  necessary  em- 


LEGISLATION    CONCERNING  TUBERCULOSIS         31 

ployees.  The  charges  shall  be  five  dollars  each  week. 
The  trustees  may  accept  a  limited  number  of  suitable  pa- 
tients, not  to  exceed  two  per  cent  of  the  total  capacity, 
for  any  sum  less  than  five  dollars  per  week.  All  patients 
admitted  shall  be  received  upon  probation  for  a  period  of 
four  weeks.  If  they  are  suitable  cases  for  sanitorium 
treatment  they  shall  be  regularly  admitted.  Compensa- 
tion for  outdoor  work  done  by  patients  shall  be  deducted 
from  the  weekly  charge.  The  superintendent  shall  make 
monthly  reports  to  the  auditor  of  state. 

Pennsylvania.  (Number  157,  1907.)  The  depart- 
ment of  health  with  the  approval  of  the  governor,  shall 
establish  one  or  more  sanatoria  or  colonies  for  the  recep- 
tion and  treatment  of  indigent  persons  affected  with  in- 
cipient tuberculosis,  and  those  so  far  advanced  with  the 
same  disease,  that  may  be  made  comfortable,  and  re- 
moved from  their  families  and  the  people  at  large  to  pre- 
vent the  spread  of  tuberculosis.  Six  hundred  thousand 
dollars  is  approriated. 

(Number  673,  1907.)  Four  hundred  thousand  dollars 
is  appropriated  to  enable  the  department  of  health  to 
establish  and  maintain  dispensaries  for  the  free  treat- 
ment of  indigent  persons  affected  with  tuberculosis,  for 
the  dissemination  of  knowledge  and  for  the  study  and  ex- 
periment of  the  disease. 

By  the  last  report  one  hundred  and  fifteen  dispensaries 
have  been  established. 

(Number  518,  1909.)  Fifteen  thousand  dollars  is  ap- 
propriated to  the  Tuberculosis  League,  Pittsburg. 

Rhode  Island.  (General  Laws,  1909,  Chapter  112.)  The 
governor  with  the  advice  and  consent  of  the  senate  shall 
appoint  a  board  of  trustees  for  the  state  sanatorium  of 


32 


five  members  only,  one  of  whom  shall  be  a  physician. 
The  board  shall  appoint  all  physicians  and  other  em- 
ployees. Patients  who  are  able  to  pay  for  their  support 
shall  pay  at  a  rate  to  be  determined  by  the  board.  The 
board  of  such  patients  as  have  a  legal  settlement  in  some 
city  or  town  shall  be  paid  by  that  city  or  town,  if  the 
patients  are  received  on  the  request  of  the  overseers  of 
the  poor  of  the  city  or  town.  The  board  may  receive 
other  indigent  patients  whose  board  shall  be  paid  by  the 
general  treasurer.  The  board  shall  fix  the  charges  for 
board.  The  board  shall  make  an  annual  report  to  the 
general  assembly. 

South  Dakota.  (Chapter  68,  1909.)  The  act  .estab- 
lishes a  sanitorium  and  farm  for  persons  afflicted  with 
tuberculosis  and  for  the  study  of  the  disease.  Ten  thou- 
sand dollars  is  appropriated  for  the  building  and  five 
thousand  dollars  annually  for  maintenance. 

Virginia.  (Chapter  361,  1908.)  The  state  board  of 
health  shall  begjin  the  erection  of  temporary  or  permanent 
buildings  or  camps  for  the  treatment  of  the  tubercular 
patients  in  the  state  at  a  minimum  expense  to  the  patient. 

Forty  thousand  dollars  is  appropriated  annually  for 
the  above  and  other  provisions  of  the  act. 

Wisconsin.  (Statutes,  Supplement,  Sections  1421 — 1 
to  1421—8  as  amended  by  Chapter  442,  1909.)  The  act 
establishes  the  Wisconsin  state  tuberculosis  sanatorium 
for  the  treatment  of  pulmonary  tuberculosis,  especially 
for  cases  in  the  incipient  stages'  of  the  disease.  The  ad- 
visory board  shall  consist  of  five  members  appointed  by 
the  governor,  at  least  two  of  whom  shall  be  physicians 
and  another  a  member  of  the  state  board  of  health.  The 
board  shall  make  a  biennial  report  to  the  state  board  of 


LEGISLATION    CTTKVERNIN$  TUBERCULOSIS         33 

control.  The  board  of  control  shall  appoint  the  superin- 
tendent. Subject  to. the  approval  of  the  board  of  control 
the  superintendent  shall  appoint  medical  assistants  and 
other  emplyees.  The  superintendent  and  board  of  con- 
trol shall  determine  the  sum  to  be  paid  by  pay  patients. 
Only  incipient  or  slightly  advanced  cases  shall  be  re- 
ceived. Each  county  shall  be  charged  with  the  mainte- 
nance of  indigent  patients  whose  application  has  been 
approved  by  the  county  judge  of  that  county.  Such 
charge  shall  be  five  dollars  per  week.  Any  person  who 
may  be  unable  to  pay  the  full  charge  of  maintenance  may 
be  received  upon  payment  of  the  amount  charged  for 
county  patients. 

LAWS  RELATIVE  TO  EXPECTORATION. 

California.  (Chapter  82,  1907.)  It  shall  be  a  misde- 
meanor for  any  person  to  discharge  mucus  from  the  nose 
or  mouth  or  spit  upon  any  sidewalk,  of  any  public  street 
or  highway  or  upon  any  part  of  any  public  building  or 
vessel  or  vehicle  used  for  the  transportation  of  the  pub- 
lic. 

Connecticut.  (Chapter  166,  1909.)  No  person  shall 
spit  on  the  paved  walk  of  any  public  street,  park  or 
square  or  upon  the  floor  of  any  hall  or  office  in  any  hotel, 
restuarant,  apartment  house,  tenement  or  lodging  house 
which  is  used  in  common  by  the  guests  or  tenants 
thereof  or  upon  the  floor,  platform,  steps,  or  stairs  of 
any  public  building,  church,  theater,  railway  station,  store 
or  factory  or  street  car  or  other  conveyance.  Penalty, 
one  to  five  dollars  or  not  more  than  thirty  days,  or  both. 

Delaware.     (Chapter    253,    1907.)     Spitting    on     the 


34         LEGISLATION    CONCERNING  TUBERCULOSIS 

floor  in  any  public  conveyance  or  car  upon  any  railway 
operating  by  any  other  power  than  steam  shall  be  a  mis- 
demeanor. Penalty,  five  or  not  more  than  ten  dollars. 

Kansas.  (Chapter  122,  1909.)  No  person  shall  spit 
upon  any  part  of  any  theater,  public  building,  or  public 
conveyance  or  any  sidewalk.  Spittoons  shall  be  pro- 
vided in  theaters  and  public  buildings  and  when  re- 
quested, in  smoking  cars.  The  dry  sweeping  of  railroad 
coaches  or  cars  on  electric  or  interurban  lines,  while  in 
transit  and  containing  passengers,  is  prohibited.  Fine, 
one  to  five  dollars. 

Louisiana.  (Chapter  91,  1908.)  Any  person  who 
shall  spit  upon  the  floor  or  walk  of  any  passenger  car, 
street  car,  depot,  or  waiting  room  or  any  public  building 
whatever,  shall  be  deemed  guilty  of  a  misdemeanor. 
Fine,  five  to  twenty-five  dollars.  Railroad  companies 
shall  supply  every  passenger  car  and  depot  or  waiting 
room  with  spittoons  and  keep  them  in  a  sanitary  condi- 
tion. They  shall  post  notices,  worded  as  follows: 
"Spitting  upon  the  floor  and  walk  forbidden  under  pen- 
alty of  the  law."  The  police  jury  of  each  parish  shall 
have  the  same  duties  in  relation  to  the  court  house  of 
that  parish. 

Maine.  (Chapter  76,  1909.)  No  person  shall  ex- 
pectorate on  any, public  sidewalk,  street  crossing  or  cross 
walk,  or  upon  the  floor  in  any  city  or  town  hall,  or  court 
house,  in  any  factory,  public  library  or  museum,  church, 
theater,  lecture  or  music  hall,  ferry  boat  or  steam  boat, 
in  any  railroad  car,  (except  smoking  car),  street  or  in- 
terurban railway  car,  railway  station,  or  on  any  side 
track  or  platform  connected  therewith.  Fine,  not  more 
than  twenty  dollars, 


LEGISLATION    CONCERNING  TUBERCULOSIS         35 

Maryland.  (Article  27,  Section  238,  Public  General 
Laws,  1904.)  It  shall  be  unlawful  to  expectorate  on  the 
floor  or  any  part  of  a  railroad  or  passenger  car.  Fine, 
three  and  one  half  dollars,  one  half  of  which  shall  go  to 
the  informer  or  party  giving  evidence.  Conductors  and 
brakemen  shall  be  empowered  to  arrest  and  take  before 
a  justice  of  the  peace  any  offender.  Smoking  cars  in 
which  no  cuspidors  are  provided  are  exempt  from  the 
operation  of  the  law. 

Massachusetts.  (Chapter  410,  1907.)  The  Mary- 
land and  Massachusetts  expectoration  laws  are  similar 
but  Massachusetts  makes  provision,  that  an  offender  may 
be  arrested  by  an  officer  authorized  to  serve  criminal 
process  in  the  place  where  the  offence  is  committed  and 
kept  in  custody  until  he  can  be  taken  before  a  court  which 
has  jurisdiction  of  such  offence ;  and,  if  his  name  is  un- 
known to  the  officer,  he  may  be  arrested  without  a  war- 
rant. 

(Chapter  104,  'Section  41,  Revised  Laws,  Supplement.) 
Cuspidors  shall  be  provided  in  all  factories  and  work- 
shops, in  such  form  and  number  as  shall  be  satisfactory 
to  the  local  board  of  health. 

Michigan.  (Act  210,  Public  Acts,  1909.)  Expector- 
ation is  prohibited  in  any  railroad,  passenger  or  street 
railway  car,  in  any  passenger  station  cr  public  waiting 
room.  The  law  does  not  apply  unless  placard  is  posted 
and  cuspidors  furnished. 

Xac  Hampshire.  (Chapter  2,  1903.)  It  shall  be  un- 
lawful for  any  person  to  spit  upon  any  sidewalk,  in  the 
compact  part  of  any  city,  village  or  town,  or  in  any  rail- 
way station,  hall  or  public  place,  or  in  any  street  or 
steam  railway  car  other  than  smoking  cars,  except  into 


36         LEGISLATION    CONCERNING  TUBERCULOSIS 

receptacles  provided  for  that  purpose.  These  receptacles 
shall  be  kept  clean  and  wholesome.  Fine,  not  exceeding 
ten  dollars. 

New  Jersey.  (Chapter  260,  1903.)  Any  person  who 
shall  spit  on  any  part  of  any  railroad  or  railway  pas- 
senger car  shall  be  deemed  to  be  a  disorderly  person; 
this  shall  not  apply  to  smoking  cars  when  these  are  not 
provided  with  cuspidors. 

(Chapter  204,  1910.)  Any  person  who  shall  spit  on 
any  part  of  any  trolley  passenger  car  shall  be  deemed  to 
be  a  disorderly  person.  Fine,  not  more  than  ten  dollars. 

Rhode  Island.  (Title  XV,  Chapter  110,  Section  33, 
General  Laws,  1909.)  No  person  shall  spit  upon  any 
part  of  any  public  conveyance,  not  exclusively  devoted  to 
smoking,  or  of  any  shop,  store,  hall,  church,  school-house, 
railroad  station  or  other  public  building,  or  in  the  hall- 
ways of  any  private  office  building,  except  into  suitable 
receptacles  provided  for  that  purpose.  Fine,  not  ex- 
ceeding twenty  dollars. 

Tennessee.  (Chapter  594,  1907.)  The  proprietor  or 
manager  of  any  building  where  business  with  the  public 
is  conducted,  and  the  owner  of  steam  railway  passenger 
coaches,  shall  provide  cuspidors  and  keep  them  disin- 
fected to  meet  the  approval  of  the  local  board  of  health, 
in  the  former  and  of  the  state  board  of  health  in  the 
latter  case.  It  shall  be  unlawful  to  spit  upon  any  part 
of  these  buildings,  public  buildings,  street  cars  or  steam 
railway  passenger  coaches.  The  proprietors,  managers 
or  owners  shall  post  the  notices  prescribed  and  supplied 
by  the  state  or  local  board  of  health.  Penalty  for  spit- 
ting as  provided  above,  fine,  two  to  five  dollars ;  genera.1 


LEGISLATION    CONCERNING  TUBERCULOSIS        3? 

penalty,  fine,  ten  to  twenty  dollars,  or  imprisonment  in 
the  county  jail  for  not  more  than  three  months  or  both. 

I'ennont.  (No.  70,  1902.)  If  a  person  shall  spit 
upon  any  part  of  a  steam  railroad,  passenger  car  or  street 
railway  car  or  upon  any  part  of  any  railroad  passenger 
station  or  public  waiting  room  he  shall  be  fined  not  more 
than  ten  dollars,  provided  that  no  prosecution  shall  be 
commenced  unless  notice  of  the  provisions  of  this  act  is 
posted  and  suitable  cuspidors  furnished,  excepting'  in 
street  railway  cars. 

(No.  187,  1906.)  A  person  who  expectorates  on  a 
pub'ic  sidewalk  or  in  a  public  building,  except  in  re- 
ceptacles provided  for  the  purpose,  shall  be  fined  not 
more  than  ten  dollars. 

Virginia.  (Chapter  302,  1906.)  No  person  shall  spit 
upon  any  part  of  any  theater,  public  building,  or  public 
conveyance,  or  upon  any  public  sidewalk  of  any  town  or 
city.  The  owner  or  lessee  of  every  theater,  public  hall, 
or  building  shall  provide  cuspidors.  Every  railroad  or 
steamship  company  shall  provide  cuspidors  in  each 
smoking  car  when  so  requested.  Copies  of  this  act 
shall  be  posted  in  all  public  buildings  and  railway  and 
street  cars.  Penalty,  fine  of  from  one  to  five  dollars, 
together  with  costs  and  in  default  of  payment,  imprison- 
ment in  city  or  county  jail  for  not  more  than  five  days. 

DISSEMINATION  OF  KNOWLEDGE  CONCERNING  TUBERCU- 
LOSIS. 

California.  (Chapter  242,  1909.)  The  state  board  of 
health  shall  disseminate  knowledge  concerning  tubercu- 
losis, its  danger,  means  of  prevention  and  cure.  Two 
thousand  dollars  is  appropriated. 


38         LEGISLATION    CONCERNING  TUBERCULOSIS 

Connecticut.  (Chapter  120,  1909.)  The  board  of  di- 
rectors (for  county  homes)  shall  take  measures  to  cause 
instruction  to  be  given  in  all  schools  of  the  state  on  the 
suppression  of  tuberculosis  and  the  maintenance  of  pub- 
lic health,  and  to  that  end  it  may  publish  tracts  and 
leaflets.  The  board  shall  encourage  the  giving  of  public 
addresses  and  the  formation  of  local  organizations  to  fur- 
ther that  end. 

loiva.  (Chapter  147,  1907.)  Five  thousand  dollars  is 
annually  appropriated  for  the  collection  and  dissemina- 
tion of  information  regarding  tuberculosis. 

Massachusetts.  (Chapter  181,  1908.)  In  each  of  the 
subjects  of  physiology  and  hygiene,  special  instruction  as 
to  tuberculosis  and  its  prevention  shall  be  taught  as  a 
regular  branch  of  study  to  all  pupils  in  all  schools  which 
are  maintained  wholly  or  in  part  by  public  money,  ex- 
cept schools  which  are  maintained  solely  for  instruction 
in  particular  branches. 

(Chapter  65,  Resolves  1910.)  One  thousand  dollars 
is  appropriated  for  the  formation  of  small  travelling 
school  tuberculosis  exhibits  to  be  used  in  the  public 
schools  for  purposes  of  instruction  in  hygiene  and  the 
prevention  of  tuberculosis. 

Montana,  (Chapter  27,  1909.)  There  shall  be  taught 
in  every  public  school  the  principal  modes  for  the  preven- 
tion of  certain  diseases  including  tuberculosis.  Data 
and  statements  shall  be  supplied  by  the  state  board  of 
health. 

New  Jersey.  (Chapter  12,  1910.)  Ten  thousand  dol- 
lars is  appropriated  annually  to  be  available  by  the  state 
board  of  health  for  educational  and  practical  purposes 
in  the  study,  treatment  and  prevention  of  tuberculosis  by 


LEGISLATION'  CONCERNING  TUBERCULOSIS         39 

(1)  publication  and  distribution  of  literature,  (2)  crea- 
tion and  maintenance  of  a  state  tuberculosis  exhibit,  (3) 
and  in  the  maintenance  of  a  special  tuberculosis  inspector 
or  inspectors,  to  be  appointed  by  the  state  board  of  health 
whose  duties  shall  be  to  enforce  existing  laws  concerning 
registration  of  tuberculous  cases,  to  advise  local  boards 
of  health  concerning  disinfection,  to  inspect  hospitals  and 
sanatoria  treating  tuberculosis  patients  and  to  report  on 
the  same  to  the  state  board  of  health,  and  to  perform 
such  other  duties  as  may  be  ordered  by  the  state  board. 

MISCELLANEOUS  PROVISIONS. 

Connecticut.  (Section  2570,  General  Statutes,  1902,  as 
amended  by  Chapter  120,  1909.)  No  employer  shall  per- 
mit any  person  afflicted  with  pulmonary  tuberculosis  to 
work  in  any  factory  for  the  preparation  of  food  stuffs, 
tobacco  and  cigars.  If  the  factory  inspector  suspects 
that  an  operator  has  pu'monary  tuberculosis,  he  shall 
.have  authority  to  cause  an  examination  to  be  made. 

Massachusetts.  (Chapter  537,  1907.)  The  governor 
shall  appoint  in  each  health  district  one  state  inspector  of 
health.  He  shall  gather  all  information  possible  concern- 
ing the  prevalence  of  tuberculosis,  shall  disseminate 
knowledge  as  to  the  best  methods  of  preventing  its  spread 
and  shall  take  such  steps  as  shall  be  deemed  advisable  for 
its  eradication. 

(Chapter  428,  1910.)  The  state  board  of  health  may 
prohibit  the  use  of  common  drinking  cups  in  such  public 
places,  vehicles  or  buildings  as  it  may  designate. 

Missouri.  (Revised  Statutes,  'Section  7866.)  No  em- 
ployer shall  knowingly  permit  any  person  to  work  in  his 


46         LEGISLATION    CONCERNING  TUBERCULOSIS 

bake  or  confectinery  shop  who  is  affected  with  tuber- 
culosis. 

Xcw  Jersey.  (Chapter  47,  1909.)  Physicians  shall 
report  to  the  state  board  of  health  within  twelve  hours 
cases  of  tuberculosis  on  any  dairy  premises  where  milk 
is  produced  for  sale. 

North  Carolina.  (Chapter  567,  1907.)  Prisoners  in 
county  or  state  prisons  who  are  affected  with  tuberculosis 
shal  be  confined  in  separate  eel's,  rooms  or  places.  These 
shall  be  used  only  for  this  purpose. 

Ohio.  (Page  319,  1910.)  The  board  of  education  in 
any  city  school  district  may  establish  such  special  ele- 
mentary schools  as  it  deems  necessary  for  youth  of 
school  age  who  are  afflicted  with  tuberculosis  and  may 
cause  all  youth,  within  such  district  so  affected,  to  be 
excluded  from  the  regu'ar  elementary  schools,  and  may 
provide  for  and  pay  from  the  school  fund,  the  expense 
of  the  transportation  of  these  to  and  from  the  special 
schools. 

Utah.  (Compiled  Laws,  Section  746x19.)  It  shall  be 
unlawful  for  any  person  affected  with  tuberculosis  to  be 
employed  in  any  bakery,  hotel,  or  restaurant  as  cook,  or 
waiter,  or  in  any  other  capacity  that  requires  the  handling 
of  food. 

BOVINE  TUBERCULOSIS. 

Connecticut.  (General  Statutes,  1902,  Section  2591.) 
The  sale  of  milk  from  a  cow  affected  with  tuberculosis  is 
prohibited. 

Delaware.  (Chapter  122,  1909.)  The  importation  of 
dairy  cows  and  other  cattle  for  breeding  purposes  is  pro- 


LEGISLATION    COXCERXIXG    TUBERCULOSIS         41 

hibited  unless  they  have  been  subjected  to  the  tuberculin 
test. 

Kansas.  (Chapter  169.  1909.)  The  live  stock  sani- 
tary commissioner  when  he  believes  or  receives  notice 
that  tuberculosis  exists  in  any  of  the  domestic  cattle  of 
the  state,  shall  make  invesigation  and  if  necessary  call 
upon  the  professor  of  veterinary  science  of  the  State 
Agricultural  College  at  Manhattan,  who.  himself  or  thru 
a  competent  veterinarian,  shall  make  an  exanrntion. 
The  tuberculin  test  may  be  used.  The  decision  of  the 
professor  or  of  the  state  veterinarian  shall  be  final.  The 
commissioner  shall  quarantine  and  brand  or  mark  all  in- 
fected animals  until  disposed  of.  The  owner  of  any  such 
animals  may  sell  them  subject  to  post  mortem  inspection, 
or  sell  them  as  diseased  animals  undei  federal  or  state 
inspection,  or  deliver  them  to  the  live  stock  sanitary  com- 
missioner in  consideration  of  an  order  on  the  county 
board  for  fifty  per  cent  of  their  appraised  value  if  they 
were  not  diseased.  The  appraisement  shall  not  exceed 
titty  dollars  for  each  pure  bred  and  registered  animal  au-i 
thirty  dollars  for  grade  or  common  cattle.  The  appraise- 
ment shall  be  made  by  the  commissioner,  or  his  deputy, 
and  the  owner.  If  they  cannot  agree  the  chairman  of 
the  county  board  or  some  one  appointed  by  him  shall  act 
as  a  third  appraiser.  The  commissioner  is  authorized  to 
?ell  animals  turned  over  to  him  for  slaughter.  The  pro- 
ceeds he  shall  turn  over  to  the  treasurer  of  the  county. 
The  owner  shall  disinfect  the  premises  at  his  own  ex- 
pense. Fine,  twenty-five  to  one  hundred  dol'ars. 

Cities  are  authorized  to  require  the  examination  and 
test  for  tuberculosis,  under  the  direction  of  the  commis- 
sioner, of  cows  from  which  milk  is  supplied  to  the  cities. 


42         LEGISLATION    CONCERNING  TUBERCULOSIS 

Maine.  (Revised  Statutes,  Chapter  19.)  Upon  the 
discovery  of  the  existence  of  tuberculosis  the  Maine 
Cattle  Commission  shall  establish  such  quarantine  of  ani- 
mals, premises  and  localities  as  it  may  deem  necessary 
to  prevent  the  spread  of  the  disease.  The  commission- 
ers shall  cause  the  appraisal  of  the  animals  affected  with 
the  disease  and  shall  cause  the  same  to  be  destroyed. 
The  appraised  value  of  an  animal  with  pedigree  shall 
not  exceed  one  hundred  dollars  and  of  an  animal  without 
pedigree,  fifty  dollars.  The  transportation  within  the 
state  or  into  the  state  of  animals  affected  with  tubercu- 
losis is  forbidden.  The  carcasses  of  animals  killed  under 
the  provisions  of  this  law  shall  be  treated  by  injection 
with  kerosene  oil.  The  carcasses  shall  further  be  buried 
or  reduced  for  fertilizer. 

(Chapter  133,  Public  Laws,  1910.)  All  pure  blood  or 
registered  and  all  grade  cattle  shown  in  competition  for 
prizes  at  state  agricultural  shows  shall  be  tested  with 
tuberculin  by  the  cattle  commission.  The  cattle  commis- 
sion shall  cause  tuberculin  tests  to  be  made  at  the  ex- 
pense of  the  state,  when  owners  of  cattle  make  applica- 
tion for  the  same.  All  grade  cattle  slaughtered  under 
orders  of  the  commission  shall  be  paid  for  at  the  ap- 
praised value  out  of  the  funds  appropriated  for  the  use 
of  the  commissioners.  The  commissioners  shall  disinfect 
the  stables  where  diseased  cattle  have  been  kept.  The 
owner  of  cattle  shipped  to  the  quarantine  station  at 
Brighton,  there  tuberculin  tested  and  condemned,  shall  be 
entitled  to  receive  not  to  exceed  fifty  dollars  for  each 
animal,  but  the  amount  received  for  the  sale  of  such  part 
of  the  animal  as  may  be  sold  shall  be  deducted  from  the 


appraised  value.  One  hundred  thousand  dollars  is  ap- 
propriated. 

Maryland.  (Chapter  365,  1908.-)  The  importation  of 
dairy  cows  and  meat  cattle  for  breeding  purposes  is  pro- 
hibited, excepting  when  they  have  been  tuberculin  tested 
by  the  proper  authorities  in  the  state  from  which  the  cat- 
tle came.  In  lieu  of  the  above  the  cattle  may  be  examined 
at  the  owner's  expense  at  stock  yards  near  the  state 
line,  or  they  may  be  shipped  to  their  destination  and 
there  quarantined  until  properly  examined  at  the  owner's 
expense  and  released  by  the  state  live  stock  sanitary 
board. 

Massachusetts.  (Revised  Laws,  Chapter  90.)  The 
board  of  cattle  commissioners  or  any  one  of  its  members 
or  agents  may  kill  cattle  afflicted  with  tuberculosis.  The 
full  value  thereof  at  the  time  of  condemnation,  not  ex- 
ceeding forty  dollars  for  any  one  animal,  shall  be  paid  to 
the  owner  by  the  commonwealth.  Animals  brought  into 
the  state  which,  in  the  opinion  of  the  board,  are  infected 
may  be  seized  and  quarantined  and,  if  safety  so  requires, 
may  be  killed  without  appraisal  or  payment.  Animals 
believed  to  be  diseased  may  be  quarantined.  If  the 
owner  cannot  agree  with  the  commissioner  as  to  the  value 
of  an  animal  the  value  shall  be  determined  by  arbitrators. 
Tuberculin  shall  be  used  only  upon  cattle  brought  into 
the  commonwealth  and  upon  cattle  at  Brighton,  Water- 
town  and  'Somerville;  but  it  may  also  be  used  on  any 
animal  in  any  other  part  of  the  commonwealth  with  the 
consent  of  the  owner  and  upon  animals  which  have  been 
condemned  as  tuberculous  upon  physical  examination  by 
a  veterinary  surgeon, 


44         LEGISLATION    CONCERNING  TUBERCULOSIS 

(Amendment  Chapter  322,  1903.)  Such  tests  by  the 
use  of  tuberculin  shall  be  made  without  charge  to  citizens 
of  the  commonwealth,  and  in  all  other  cases  the  expense 
of  such  tests  shall  be  paid  by  the  owner  of  such  animals. 

Michigan.  (No.  172,  Pub'ic  Acts,  1909.)  In  case  of 
the  killing  of  tuberculous  cattle  as  diiected  by  the  state 
live  stock  sanitary  commission,  it  shall  appraise  the  ani- 
mals condemned.  The  owner  shall  receive  fifty  per  cent 
of  the  value  of  the  animal  as  though  not  diseased,  such 
per  cent  in  no  case  to  be  reckoned  on  a  sum  over  fifty 
dollars,  provided  that  premises  have  been  kept  in  sani- 
tary condition,  nor  shall  they  receive  compensation  until 
the  infected  premises  have  been  disinfected.  The  com- 
mission shall  have  power  to  order  the  slaughter,  under 
federal  inspection,  of  cattle  that  have  reacted  to  the 
tuberculin  test. 

If  the  cattle  are  not  condemned  the  owner  shall 
receive  the  proceedfe  less  the  cost  of  shipping,  etc., 

If  the  cattle  are  condemned  the  owner  shall  receive  the 
proceeds  from  the  sale  of  the  hide,  tallow,  etc.,  after  de- 
ducting the  cost  of  handling,  etc.,  in  addition  to  the  above 
mentioned  fifty  per  cent  of  the  appraised  value.  The 
importation  of  cattle  into  the  state  is  prohibited  unless 
tuberculin  tested  sixty  days  prior  to  shipment. 

Minnesota.  (Revised  Laws,  Chapter  30.)  When  a 
veterinarian  appointed  by  the  state  live  stock  sanitary 
board  has  inspected  .cattle  for  tuberculosis  and  has  pro- 
nounced them  diseased  they  shall  be  killed.  Appraisers 
appointed  by  the  state  board  and  owners  shall  fix  the 
value  of  the  cattle.  The  value  of  the  carcass  shall  be 
deducted  from  ithat  of  the  living  animal,  and  three- 
fourths  of  the  remainder  shall  be  paid  to  the  owners  by 


LEGISLATION    CONCERNING   TUBERCULOSIS         45 

the  state,  provided  that  the  appraised  value  shall  not 
exceed  thirty-five  dollars. 

(Chapter  355,  1907.)  It  shall  be  unlawful  for  any 
transportation  company  to  bring  into  the  state  any  cattle 
unless  they  have  been  examined  and  found  free  from 
tuberculosis  by  the  proper  authorities  of  the  state  from 
which  they  are  shipped,  or  by  a  veterinarian  of  the 
United  States  bureau  of  animal  industry  or  by  a  veteri- 
narian acting  under  the  direction  of  the  live  stock  sani- 
tary board  of  th's  state.  In  any  case  where  cattle  are 
brought  into  the  state  without  examinaion  transportation 
companies  shall  hold  the  cattle  at  the  first  station  within 
Minnesota  where  there  are  suitable  facilities  for  inspect- 
ing them.  This  inspection  shall  be  made  at  the  expense 
of  the  owner. 

(Chapter  445,  1909.)  The  board  shall  furnish  tuber- 
•culin  and  mallein  among  licensed  veterinarians  regardless 
of  whether  such  are  graduates  of  a  veterinary  college  or 
not.  The  board  shall  keep  record  of  all  applications. 

Montana.  (Revised  Codes.  Sections  1884  to  1903.) 
Animals  determined  by  either  the  state  veterinary  sur- 
geon or  a  deputy  to  be  affected  with  tuberculosis  may  be 
slaughtered.  No  animals  of  this  class  shall  be  paid  for, 
save  when  a  mistake  as  to  the  existence  of  a  slaughter- 
able disease  is  discovered  upon  autopsy.  The  valuation 
shall  not  exceed  the  following :  For  common  bloods,  not 
exceeding  thirty-five  dollars,  for  any  male  animal,  four 
years  old  and  upwards,  and  for  any  female  animal  four 
years  old  and  upwards,  not  exceeding  twenty-five  dol- 
lars and  proportionately  less  for  lesser  ages.  For  graded 
stock,  not  exceeding  forty  dollars  for  any  male  animal 
four  years  old  and  upwards,  and  for  any  female  animal 


46         LEGISLATION    CONCERNING  TUBERCULOSIS 

four  years  old  and  upward  not  exceeding  thirty-five  dol- 
lars, and  proportionately  less  for  lesser  ages.  And  for 
all  full  bloods,  for  any  male  animal  four  years  old  and 
upwards  not  exceeding  one  hundred  dollars,  and  for  any 
female  animal  four  years  old  and  upward  not  exceeding 
seventy-five  dollars  and  proportionately  less  for  lesser 
ages. 

New  Jersey.  (Chapter  317,  1894,  as  amended  by 
chapter  148,  1898,  and  chapter  80,  1901.)  Whenever  the 
state  tuberculosis  commission  shall  be  requested  by  the 
secretary  of  the  state  board  of  health  or  the  dairy  com- 
missioner or  any  owner  of  dairy  animals,  it  shall  desig- 
nate a  person  to  inspect  the  animals  supposed  to  be 
diseased  with  tuberculosis.  If  these  cannot  agree  on  a 
valuation  each  shall  choose  one  disinterested  freeholder,, 
who  shall  choose  a  third  and  these  shall  appraise  the 
value  of  the  animals.  If  the  animal  is  slaughtered  the 
owner  shall  receive  three-fourths  of  the  appraised  value,, 
but  the  appraised  value  shall  not  exceed  forty  dollars. 

'New  York.  (Consolidated  Laws,  Agricultural  Law, 
Sections  93,  94,  64-a.)  The  commissioner  of  agriculture 
may  have  tuberculous  animals  killed  if  found  so  by  physi- 
cal examination.  The  tuberculin  test  may  be  applied  if 
the  owner  desires.  If  the  animal  responds  the  commis- 
sioner shall  cause  it  to  be  slaughtered  or  held  in  quaran- 
tine. If  it  is  held  in  quarantine  the  milk  may  be  used  if 
pasteurized.  The  young  of  such,  animals  shall  be  separ- 
"  ated  from  the  mothers,  but  they  may  be  fed  the  pasteur- 
ized milk.  Upon  the  application  of  the  owner  of  a  herd 
of  cattle  and  "his  agreement  to  improve  faulty  sanitary 
conditions,  to  disinfect  his  premises  should  tuberculosis 
be  found  and  to  follow  the  instructions  of  the  commis- 


LEGISLATION    CONCERNING    TUBERCULOSIS         47 

sioner,  the  commissioner  shall  cause  the  ntrd  to  be  ex- 
amined. No  person  shall  sell  any  animal  known  to  have 
a  communicable  or  infectious  disease  except  for  immedi- 
ate slaughter  unless  such  sale  be  made  under  a  written 
contract  signed  by  both  parties,  specifying  the  disease  of 
the  animal.  One  copy  shall  be  filed  with  the  commis- 
sioner of  agriculture.  Any  person  making  a  tuberculin 
test  shall  report  the  results  to  the  commissioner  of  agri- 
culture. No  certificate  shall  be  given  unless  the  charac- 
ter of  such  test  is  stated,  and  unless  it  failed  to  give  a 
proper  reaction.  Tubercular  bovine  animals  shall  be 
branded  on  the  forehead  or  on  the  right  side  of  the  neck 
from  six  to  ten  inches  back  of  the  jaw  bone  with  a  capi- 
tal "T"  not  less  than  two  inches  high,  one  and  one  half 
inches  wide,  with  a  mark  one  fourth  of  an  inch  wide. 
If  the  animal  reacted  to  the  tuberculin  test  and  appears 
physically  sound  it  may  be  retained  for  breeding  or  dairy 
purposes  without  such  branding,  but  a  description  of  the 
animal  must  be  furnished  to  the  commissioner  of  agri- 
culture, and  the  animal  cannot  be  removed  without  the 
written  permission  of  the  commissioner.  Persons  selling 
or  giving  away  tuberculin  shall  report  the  amount  sold 
or  given  away  to  the  commissioner  of  agriculture.  No 
person  shall  treat  bovine  animals  so  as  to  prevent  normal 
reaction.  No  animal  that  has  reacted  to  the  test  shall  be 
sold  or  removed  without  permission  in  waiting  from  the 
commissioner.  No  person  shall  sell  or  offer  for  sale  an 
animal  that  has  responded  to  the  test  without  giving  this 
information  to  the  buyer. 

(Consolidated  Laws,  Agricultural  Law,  Sections  99  to 
•102,  as  amended  by  Chapter  670,  1910.)  An  appraiser 
appointed  by  the  commissioner  of  agriculture,  shall  deter- 


48         LEGISLATION    CONCERNING  TUBERCULOSIS 

mine  the  value  of  the  animal  to  be  slaughtered,  but  the 
appraised  value  shall  not  exceed  seventy-five  dollars,  ex- 
cept in  the  case  of  registered  thoroughbred  animals,  when 
it  shall  not  exceed  one  hundred  and  twenty-five  dollars. 
In  case  of  dispute  arbitrators  shall  be  selected  to"  decide. 
If  the  animal  is  found  to  have  localized  tuberculosis  the 
owner  shall  be  paid  eighty  per  cent  of  the  appraised 
value,"  if  generalized  tuberculosis,  fifty  per  cent.  If  the 
meat  of  the  slaughtered  bovine  animal  shall  be  passed 
fro  use  as  food,  under  official  regulation,  the  commis- 
sioner is  authorized  to  sell  the  same  and  the  proceeds 
shall  be  paid  into  the  staite  treasury. 

North  Dakota.  (Chapter  160,  190(J.)  Cattle  that 
have  been  proven  to  be  tubercular  by  the  tuberculin  test 
after  having  been  tested  by  a  legally  qualified  and  duly 
authorized  veterinary  surgeon  or  the  owi;er  of  such  cattle 
or  his  agent  shall  be  immediately  marked  by  punching 
the  letter  "T"  in  the  left  ear,  the  letter  not  to  be  les^ 
than  one  inch  in  height  and  breadth.  Penalty,  fine  of 
from  ten  to  fifty  dollars  or  confinement  in  the  county 
jail  from  ten  to  twenty  days  or  both. 

Oregon.  (Chapter  213,  1909.)  The  state  or  county 
veterinarian  is  empowered  to  kill  animals  afflicted  with  a 
dangerous  or  incurable  disease,  provided  that  tubercu- 
losis be  not  considered  a  slaughterable  disease,  unless  the 
animal  shows  visible  symptoms  of  the  disease.  No  ani- 
mal shall  be  tested  with  tuberculin  unless  request  is 
made  by  the  owner.  The  importation  of  no  cattle  for 
breeding  or  dairy  purposes  shall  be  permitted  unless  they 
shall  be  accompanied  by 'a  certificate  of  a  tuberculin  test 
made  by  an  employee  of  the  United  States  Bureau  of' 
Animal  Industry  or  by  any  other  approved  veterinarian, 


LEGISLATION    CONCERNING   TUBERCULOSIS        4& 

showing  that  they  are  free  from  tuberculosis  or  unless 
the  cattle  be  tested  with  tuberculin  by  the  proper  officer 
within  ten  days  after  arrival  within  the  state.  The  state 
veterinarian  or  county  veterinarian  shall  test  all  cows 
that  supply  milk  to  state  institutions,  at  least  once  a  year. 
If  they  react  to  the  tuberculin  test  the  sale  of  the  milk 
.shall  be  prohibited  and  the  animals  removed  from  the 
dairy  herd.  Officers  of  such  institutions  shall  report 
every  six  months  the  names  of  persons  supplying  milk  to 
these  institutions.  Every  veterinarian  practicing  shall 
report  to  the  state  veterinarian  or  the  state  board  of 
health  all  cases  of  tuberculosis  he  may  find. 

Pennsylvania,  (Purdons  Digest,  Page  1259.)  The 
importation  of  dairy  cows  and  meat  cattle  for  breeding 
.purposes  is  prohibited,  excepting  when  they  are  accom- 
panied by  a  certificate  from  the  proper  authority  in  the 
state  whence  the  cattle  came,  certifying  that  they  had  been 
subjected  to  the  tuberculin  test  and  are  free  from  disease. 
In  lieu  of  this  certificate  the  cattle  may  be  detained  at 
suitable  stock  yards  nearest  to  the  state  line  and  there 
examined  at  the  expense  of  the  owner,  or  they  may  be 
shipped  to  their  destination,  there  to  remain  in  quaran- 
tine until  properly  examined  a"  the  owner's  expense,  and 
released  by  the  state  live  stock  sanitary  board. 

Rhode  Island.  (General  Laws,  Chapter  120.)  When- 
ever an  animal  is  suspected  by  either  of  the  cattle  com- 
missioners to  be  affected  with  tuberculosis,  the  commis- 
sioner of  the  county  shall  notify  the  secretary  of  the 
state  board  of  agriculture  who  shall  fix  a  day  when  the 
appraisers  shall  appraise  the  animal.  If  it  is  affected  the 
animal  shall  be  killed,  and  the  state  shall  pay  the  owner 
one  half  of  the  appraised  value;  if  it  is  not  affected  the 


50 


state  shall  pay  the  full  appraised  value.  The  cattle  com- 
missioners of  the  counties  shall  see  that  the  premises  be 
cleaned  and  disinfected.  A  person  shipping  cattle  into 
the  state  must  produce  a  certificate  that  the  animal  is 
free  from  tuberculosis  as  determined  by  a  physical  ex- 
amination and  tuberculin  test.  If  the  importer  has  no 
certificate  he  shall  give  a  written  notification  and  descrip- 
tion of  the  an:mals  to  the  commissioner  of  the  county 
who  shall  make  a  physical  examination  and  if  necessar)' 
apply  the  tuberculin  test.  If  the  animal  responds  it  shall 
be  slaughtered,  and  no  compensation  shall  be  made  by 
the  state.  If  upon  slaughter  no  affection  is  shown  the 
owner  shall  receive  the  full  appraisal  value. 

Utah.  (Compiled  Laws,  Section  746.)  No  person 
selling  or  furnishing  milk  or  dairy  products  shall  have 
in  his  possession,  at  any  place  where  milch  cows  are 
kept,  any  cattle  having  tuberculosis.  The  dairy  and  food 
commissioner  shall  cause  all  cattle,  kept  in  violation  of 
this  act,  to  be  killed. 

Vermont.  (Number  163,  1908.)  All  cattle  brought 
into  the  state  shall  be  examined  by  the  cattle  comrnis^- 
sioner.  He  shall  if  he  deems  necessary  apply  the  tuber- 
culin test.  Those  found  diseased  shall  be  deported  or 
slaughtered.  The  owner  of  diseased  cattle  shall  notify 
the  commissioner  who  shall  make  a  physical  exami- 
nation, and  if  necessary  he  may  apply  the  tuberculin  test. 
If  the  animals  are  affected  he  shall  cause  them  to  be 
killed  or  disposed  of.  Whenever  the  cattle  commissioner 
has  reason  to  believe  that  tuberculosis  exists  in  any  herd 
he  may  order  a  thorough  examination  and,  if  necessary, 
apply  the  tuberculin  test.  The  same  proceedings  shall 
apply  as  in  the  case  above.  All  barns  in  which  diseased 


LEGISLATION   CONCERNING   TUBERCULOSIS        51 

-animals  have  been  kept  shall  be  disinfected  at  the  owner's 
expense.  The  expense  of  the  slaughtering  and  disin- 
fecting shall  be  paid  by  the  owner.  The  value  of  cattle 
condemned  shall  be  appraised  by  the  owner  and  the 
commissioner  and  if  they  cannot  agree  a  third  party 
shall  be  selected.  The  appraised  value  shall  not  exceed 
fifty  dollars.  The  owner  shall  receive  seventy-five  per 
cent  of  the  appraised  value,  and  in  addition,  the  hide  of 
the  slaughtered  air'mal.  The  commissioner  may  dispose 
of  animals  affected  with  tuberculosis  at  some  fertilizer 
or  rendering  plant  or  at  any  place  where  they  are  in- 
spected under  federal  authority.  The  proceeds  of  the 
sale  of  the  carcass  shall  go  to  the  state.  If  a  person 
ships  milch  cows  to  Massachusetts,  subject  to  the  tuber- 
culin test,  and  if  the  cows  respond  to  the  test  and  the 
Massachusetts  board  of  cattle  commissioners  condemns 
or  refuses  to  accept  them,  he  may  sell  them  at  the  highest 
price  obtainable  under  the  Massachusetts  regulations. 
The  cattle  commissioner  of  this  state  shall  then  draw 
an  order  for  a  sum  equal  to  seventy-five  per  cent  of  the 
purchase  price  of  such  animals,  less  the  amount  received 
for  them  in  Massachusetts ;  but  this  shall  not  be  reckoned 
on  more  than  fifty  dollars  for  each  animal.  Any  resident 
of  this  state  who  slaughters  an  animal  for  human  con- 
sumption and  finds  after  slaughter  that  it  is  tuberculous 
may  notify  the  cattle  commissioner,  who,  after  an  ex- 
amination, shall  draw  an  order  in  favor  of  the  owner 
for  the  sum  of  seventy-five  per  cent  of  the  appraised 
value  thereof ;  the  appraised  value  shall  not  exceed  fifty 
dollars. 

The  commissioner  shall  have  an  ear  tag  inserted  in 
the  ear  of  every  animal  that  was  tuberculin  tested  under 


the  provisions  of  this  act  and  passed  the  test  satisfac- 
torily. 

Forty  thousand  dollars  is  appropriated  annually. 

Virginia.  (Chapter  335,  1910.)  Under  the  direction 
of  the  live  stock  sanitary  board  and  the  state  dairy  and' 
food  commissioner,  the  state  veterinarian  and  the  vet- 
erinarian of  the  Virginia  experiment  station  shall  apply 
the  tuberculin  test  to  breeding  or  dairy  cattle  if  the 
owners  so  request.  If  the  animal  reacts  it  shall  be  sur- 
rendered to  the  state.  The  owner  shall  receive  a  sum  not 
to  exceed  forty  dollars,  but  if  it  a  pure-bred  and  regis- 
tered animal,  unless  segregated  under  the  Bangs  method, 
the  owner  shall  receive  not  to  exceed  eighty  dollars. 
The  dairy  and  food  commissioner  shall  make  an  annual 
report  of  examinations  and  tests  made. 

West  Virginia.  (Code  1906,  'Sections  368,  371,  372.) 
The  state  veterinarian  may  kill  animals  affected  with 
tuberculosis  if  he  finds  it  necessary  or  expedient  to 
prevent  a  spread  of  the  disease.  The -disinterested  per- 
sons shall  appraise  the  value  of  the  animals.  The  owner 
shall  receive  the  full  appraised  value. 

Wisconsin.  (Chapter  542,  1909.)  When  the  live 
stock  sanitary  board  shall  deem  it  necessary  to  slaughter 
a  diseased  animal  the  owner  and  three  disinterested  citi- 
zens shall  appraise  the  value  thereof.  The  appraised 
value  shall  not  exceed  fifty-five  dollars.  In  case  of  tu- 
berculosis the  live  stock  sanitary  board  may  ship  the  an- 
imal at  the  expense  of  the  state  to  some  abattoir  to  be 
killed  under  federal  inspection.  The  net  proceeds  of 
such  sale  shall  go  to  the  state.  If  the  animal  reacts  to 
the  tuberculin  test,  but  no  lesions  are  found  upon  slaugh- 
ter, the  owner  shall  receive 'the  full  amount  of  the  ap- 


LEGISLATION    CONCERNING    TUBERCULOSIS         53 

praisal ;  the  owner  shall  receive  three-fourths  for  all 
other  animals  so  slaughtered.  It  shall  be  unlawful  to 
sell  any  cow,  bull  or  heifer  of  the  bovine  family,  over 
six  months  old,  unless  to  be  exported  or  slaughtered,  if  it 
has  not  been  tuberculin  tested  and  found  to  be  free  from 
tuberculosis  by  the  proper  authorities  within  two  years 
prior  to  the  sale.  The  evidence  of  such  test  shall  ac- 
company the  animal. 

(Chapter  304,  1907.)  Any  person  who  shall  use  tuber- 
culin or  any  other  agent  upon  cattle  for  the  purpose  of 
preventing  a  proper  reaction  when  the  tuberculin  test 
is  made  shall  be  guilty  of  a  misdemeanor  and  subject  to 
the  penalty  of  a  fine  of  from  two  hundred  to  five  hun- 
dred dollars  or  imprisonment  for  six  months  to  one  year 
or  both. 

(Chapter  272,  1905,  as  amended  by  Chapter  542,  1909.) 
No  cattle  shall  be  brought  into  the  state  for  other  pur- 
poses than  to  be  slaughtered,  unless  they  are  accompanied 
by  a  certificate  showing  that  the  catt'e  were  subjected  to 
the  tuberculin  test  within  six  months  pnor  to  the  ship- 
ment a.nd  were  free  from  tuberculosis.  In  leiu  of  such 
an  inspection  certificate  the  cattle  shall,  upon  request  of 
the  owner,  be  shipped  in  quarantine  into  the  state  to  be 
examined,  at  the  expense  of  the  owner,  by  an  inspector 
appointed  by  the  live  stock  commission.  If  cattle  are 
"brought  into  the  state  for  breeding  or  dairy  purposes 
without  a  certificate  of  inspection  the  railroad  company 
and  the  owner  shall  notify  the  secretary  of  the  live  stock 
sanitary  board  at  Madison,  Wisconsin,  and  these  cattle 
shall  be  examined  by  an  inspector,  at  expense  of  the 
owner  or  shipper.  The  owner  may  re-ship  affected  ani- 
mals. The  owner  or  shipper  shall  receive  no  indemnity 
if  cattle  are  slaughtered. 


54         LEGISLATION    CONCERNING  TUBERCULOSIS 
EXPENDITURES  FOR  TUBERCULOSIS  WORK  IN  1910.1 


State. 

Public.  " 

Private.  • 

Total. 

Alabama  

$2,000 

$5.500 

87,500 

Alaska  

1,000 

1,000 

Arizona  

4,000 

76.000 

80.000 

Arkansas  

68,OOJ 

1,000 

69,000 

California  

88.000 

316,000 

4(M,(KX> 

Colorado  

105,000 

731.000 

836,  000. 

Connecticut  

338,500 

167,500 

506,000 

Delaware  

15,500 

18.000 

33,500- 

District  of  Columbia  

41,000 

8,500 

49,  500 

Florida..     .  . 

500 

500 

(ieoryia  

54,500 

46,500 

101,000- 

Hawaii  

6,000 

9,000 

15,000 

Idaho...   . 

Illinois  

245.000 

208.000 

453.  000' 

Indiana  

157.000 

48.000 

205,000 

Iowa  

119.500 

11.500 

131,000- 

Kansas  

10,500 

1,500 

12,000 

Kentucky  

127,000 

42.000 

169.000 

Lou  siana  

16.  000 

62,000 

78.000 

Main*5..  

62,000 

54,000 

116,000 

Maryland  

130,500 

95.000 

225.500 

Massachusetts  
Michigan  

1  118.000 
8(5,000 

400,  000 
85,000 

1.518,000 
171,000- 

Minnesota  

126.000 

65,000 

191,000 

Mississippi  

5,000 

500 

5,500 

Missouri  

200,000 

35.000 

235.000 

Montana  ... 

100 

400 

500- 

Nebraska  

1,000 

1,000 

2,000 

Nevada 

New  Hampshire  

23,000 

7.000 

30.000 

New  Jersey.        

255,000 

130,700 

385,700 

New  Mexico  

250,000 

251.000 

501,000 

New  York  

3,039,000 

1.206,000 

4,245.000 

North  Carolina 

42,000 

168,000 

210,000 

North  Dakota  

1,000 

1.000 

Ohio  

573,500 

76,000 

649.500 

Oklahoma  .•  

1.500 

300 

1,800 

Oregon  

56.000 

25,550 

81,550 

Pennsylvania  

1,431,000 

673.000 

2,104,000 

Philippine  Islands  

20,000 

100 

20,100 

Porto  Rico  

23,300 

5,000 

28,300 

Rhode  Island  

81,500 

51,500 

133,000' 

South  Carolina  

1.000 

6,700 

7,700 

South  Dakota    .                

10,000 

15,000 

25,000 

Tennessee  

16,  500 

54,000 

70.500 

Texas.,.. 

46,000 

122,000 

168,000 

Utah 

Vermont  

2.000 

20,500 

22,500 

Virginia  

45,500 

55,500 

101,000 

Washington.  

13.000 

73,000 

86,000 

West  Virginia  

1.100 

2,500 

3,600 

Wisconsin  

210,000 

99,000 

309,000 

400 

400 

Total....... 

S9.267.9002 

$5.  532.  250 

$14,800,150- 

1  Journal  of  Outdoor  Life,  January.  1911,  Philip  P.  Jacobs. 
*  This  includes  not  only  state  appropriations  but  the  expenditures  from, 
all  public  sources. 


LEGISLATION    CONCERNING   TUBERCULOSIS         55 

The  following  table  gives  the  amount  in  each  group  for 
1909  and  1910 : 


Class. 

Money  spent 
in  1910. 

Money  spent 
in  1909. 

Sanatoria  

ill,  376.  500 

15,300.000 

Associations  

760,500 

975,000 

Dispensaries 

SS9  000 

650  000 

Municipal  work.             .     ... 

1,055.000 

1  115  000 

State  work  

719,000 

Total  

$14,800,000 

$8,180,000 

56          LEGISLATION    CONCERNING    TUBERCULOSIS 


BIBLIOGRAPHY. 

Bardswell,    Noll    D.     The    consumptive    working    man; 
what  can  sanatoria    do    for    him  ?     The    Scientific 
Press,  limited,  London,  1906. . 
Behring,  E.  von.     The  suppression  of  tuberculosis.   New 

York.     J.  Wiley  &  sons,  1904. 

Brisco,  Charles  F.,  and  MacNeal,  W.  J.  Tuberculosis 
of  farm  animals.  University  of  Illinois,  Agricul- 
tural experiment  station,  bulletin  no.  149.  Urbana, 
111.,  1911. 

Control  of  bovine  tuberculosis.     Report  of  the  Interna- 
tional commission  of  the  American  veterinary  medical 
association,  1910.     United  States  department  of  ag- 
riculture, Bureau  of  animal  industry,  circular  175. 
Fanning,  F.  W.  Burton.     The  open  air  treatment  of  pul- 
monary tuberculosis.     Cassell  and   Company,   Lim- 
ited, London,  Paris,  New  York  and  Melbourne,  1905. 
Francine,    Albert    Philip.     Pulmonary    tuberculosis,    its 
modern  and  specialized  treatment.     Philadelphia  and 
London,  J.  B.  Lippincott  Company,  1907. 
Huber,  John  Bessner.     Consumption ;  its  relation  to  man 
and  his  civilization ;  its  prevention  and  cure.     Phil- 
adelphia and  London,  J.  B.    Lippincott    Company, 
1906. 

Jacobs,  Philip  P.  The  campaign  against  tuberculosis  in 
the  United  States,  including  a  directory  of  institu- 
tions dealing  with  tuberculosis  in  the  United  States 
and  Canada ;  compiled  under  the  direction  of  the 


LEGISLATION   CONCERNING    TUBERCULOSIS         5T 

National  association  for  the  study  and  prevention  of 
tuberculosis.  New  York,  Charities  publication  com- 
mittee, 1908. 

Klebs,  Arnold  Carl.  Tuberculosis.  New  York  and  Lon- 
don. D.  Appleton  and  Company,  1909. 

Knopf,  S.  A.  Tuberculosis  as  a  disease  of  the  masses,, 
and  how  to  control  it.  New  York,  M.  Firestack,. 
1905. 

Melvin,  A.  D.  Economic  importance  of  tuberculosis  of 
food-producing  animals.  United  States  department 
of  agriculture,  25th  annual  report  of  the  Bureau  of 
animal  industry. 

National  association  for  the  study  and  prevention  of 
tuberculosis.  Annual  transactions.  105  Bast  22d 
Street.  \e\v  York. 

Newsholme,  Arthur.  The  prevention  of  tuberculosis. 
E.  P.  Dutton  and  company,  31  West  23d  street,  New 
York,  1908. 

Pearson,  Leonard  and  Ravenel,  M.  P.  Tuberculosis  of 
cattle  and  Pennsylvania  plan  for  its  suppression. 
Pennsylvania  department  of  agriculture,  bulletin  75. 

Sixth  International  congress  on  tuberculosis.  Proceed- 
ings, 1908. 

Tscholl  Rev.  John.  War  on  the  white  plague.  Chris- 
hold.  Minn. 

Tuberculosis  in  the  United  States.  Department  of  Com- 
merce and  labor.  Bureau  of  the  census.  1908.  pp. 
41-45. 

Walters,  F.  R.  The  open-air  or  sanatorium  treatment 
of  pulmonary  tuberculosis.  Bailliere,  Tindall  and 
Cox.  8.  Henrietta  Street,  Covent  Garden,  1909,  Lon- 
don. 


loret  ; 


GAYLAMOUNTd 
PAMPHLET  BINDER 
Syracuse,  N.Y. 
Stockton,  Colif.l 


